Dementia 02
Topic: Imaging
Created on Thursday, February 22 2007 by jdmiles
Last modified on Thursday, February 22 2007.
A 78 year-old male presents to your office accompanied by his guardian, who provides most of the history.
The guardian states that for the past 5 years, the patient occasionally mentions that he is seeing visions of old silver electric eels, has had dramatic fluctuations in his level of arousal, has complained of a tremor in his hands, has fallen several times, has been increasingly slow getting around, and has had more and more trouble remembering things.
Which of the following pathology findings is MOST characteristic of this patient's disease?
A) Lewy bodies B) Amyloid plaques C) Inclusions comprised primarily of head cheese D) Punctate hemorrhages in periaqueductal grey and in the grey matter surrounding the 3rd and 4th ventricles E) Neuronal aggregates
This question was created on February 22, 2007 by jdmiles.
This question was last modified on February 22, 2007.
ANSWERS AND EXPLANATIONS
A) Lewy bodies
This answer is correct.
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 which contain alpha-synuclein. (
See References)
B) amyloid plaques
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. Amyloid plaques are seen in DLB, but widespread Lewy bodies are a more defining feature. (
See References)
C) inclusions comprised primarily of head cheese
This answer is incorrect.
No. No, no, no. You are wrong. There is no head cheese in Lewy bodies. You are a silly person. (
See References)
D) punctate hemorrhages in periaqueductal grey and in the grey matter surrounding the 3rd and 4th ventricles
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. Punctate hemorrhages in periaqueductal grey and in the grey matter surrounding the 3rd and 4th ventricles are seen in Wenicke encephalopathy. (
See References)
E) neuronal aggregates
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. Neuronal aggregates and Bunina bodies are seen in amyotrophic lateral sclerosis. (
See References)
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