There are 484 questions on various topics in Neurology in the FrontalCortex neurology question bank.

Dementia 02

Topic: Imaging

Created on Thursday, February 22 2007 by jdmiles

Last modified on Thursday, February 22 2007.

A 84 year-old male presents to your office accompanied by his caretaker, who provides most of the history.
The caretaker states that for quite some time now, the patient occasionally will stare off into space for long periods of time, has been increasingly forgetful, has complained of seeing people in the room that nobody else sees, has complained of rigidity, lost his balance a few times, and has had increasing difficulty inititiating movement.
Which of the following pathology findings is MOST characteristic of this patient's disease?

A) Inclusions comprised primarily of tau protein

B) Lesions in the mammillary bodies

C) Inclusions comprised primarily of Huntingtin

D) Inclusions comprised primarily of alpha-synuclein

E) Neurofibrillary tangles,

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This question was created on February 22, 2007 by jdmiles.
This question was last modified on February 22, 2007.

ANSWERS AND EXPLANATIONS

A) inclusions comprised primarily of tau protein

This answer is incorrect.

This patient's history is consistent with dementia with Lewy bodies (DLB). Patients with DLB develop Parkinsonian symptoms and dementia symptoms at approximately the same time. Other key clinical features include recurrent visual hallucinations and fluctuations in mental status. Lewy bodies are eosinophilic cytoplasmic inclusions comprised mainly of alpha-synuclein, not tau protein. (See References)

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B) lesions in the mammillary bodies

This answer is incorrect.

This patient's history is consistent with dementia with Lewy bodies (DLB). Patients with DLB develop Parkinsonian symptoms and dementia symptoms at approximately the same time. Other key clinical features include recurrent visual hallucinations and fluctuations in mental status. Lesions in the mammillary bodies are seen in Korsakoff amnestic state. (See References)

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C) inclusions comprised primarily of Huntingtin

This answer is incorrect.

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D) inclusions comprised primarily of alpha-synuclein

This answer is correct.

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E) neurofibrillary tangles,

This answer is incorrect.

This patient's history is consistent with dementia with Lewy bodies (DLB). Patients with DLB develop Parkinsonian symptoms and dementia symptoms at approximately the same time. Other key clinical features include recurrent visual hallucinations and fluctuations in mental status. Neurofibrillary tangles tend to be sparse in DLB. Neurofibrillary are more commonly associated with Alzheimer disease. (See References)

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References:

1. Victor, M., and Ropper, A.H. (2001). Adams and Victor's Principles of Neurology, 7th Edition. McGraw-Hill, New York.
2. DeKosky, S.T., Kaufer, D.I., and Lopez, O.L. (2004). The Dementias. In Bradley, W.G., Daroff, R.B., Fenichel, G.M., and Jankovic, J. (Eds.). Neurology in Clinical Practice, 4th Edition. Butterworth Heinemann, Philadelphia. Pp. 1901-1951
3. Prayson, R.A., and Goldblum, J.R. (Eds.) (2005). Neuropathology. Elsevier, Philadelphia.

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imaging
Dementia 02
Question ID: 02220701
Question written by J. Douglas Miles, (C) 2006-2009, all rights reserved.
Created: 02/22/2007
Modified: 02/22/2007
Estimated Permutations: 0