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Dementia 02

Topic: Imaging

Created on Friday, February 23 2007 by jdmiles

Last modified on Friday, February 23 2007.

A 86 year-old female presents to your office accompanied by her son, who provides most of the history.
The son states that for quite some time, the patient has complained of seeing people in the room that nobody else sees, has had periods when she is lethargic and drowsy, and others when she is more alert, lost his balance a few times, has been increasingly forgetful, has complained of stiffness, and developed a tremor.
Which of the following pathology findings is MOST characteristic of this patient's disease?

A) Lesions in the mammillary bodies

B) Eosinophilic cytoplasmic inclusions

C) Eosinophilic nuclear inclusions

D) Neuronal aggregates

E) Inclusions comprised primarily of tau protein

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This question was created on February 23, 2007 by jdmiles.
This question was last modified on February 23, 2007.

ANSWERS AND EXPLANATIONS

A) 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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B) eosinophilic cytoplasmic inclusions

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) eosinophilic nuclear inclusions

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. (See References)

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D) 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)

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E) 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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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: 02/23/2007
Modified: 02/23/2007
Estimated Permutations: 0