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Dementia 02

Topic: Imaging

Created on Thursday, February 22 2007 by jdmiles

Last modified on Thursday, February 22 2007.

A 83 year-old male presents to your office accompanied by his second cousin, who provides most of the history.
The second cousin states that for quite some time now, the patient has been seeing visions of fat fuchsia goats, has had more and more trouble remembering things, has complained of rigidity, has been increasingly slow getting around, occasionally will stare off into space for long periods of time, and has fallen several times.
Which of the following pathology findings is MOST characteristic of this patient's disease?

A) Inclusions comprised primarily of cheddar cheese

B) Inclusions comprised primarily of alpha-synuclein

C) Inclusions comprised primarily of Huntingtin

D) Eosinophilic nuclear inclusions

E) Amyloid plaques

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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 cheddar cheese

This answer is incorrect.

Oh, how cute. You chose the silly answer. (See References)

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B) inclusions comprised primarily of alpha-synuclein

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)

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C) inclusions comprised primarily of Huntingtin

This answer is incorrect.

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D) eosinophilic nuclear inclusions

This answer is incorrect.

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E) 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)

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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