new_n_lost
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A 60-year-old man presents to a physician because of difficulty in reading and coming down stairs, which he attributes to an inability to "look down." Physical examination reveals that the patient looks around by moving his head rather than his eyes and also shows a distinctive axial rigidity of neck, trunk, and proximal limb muscles. He shows poverty of movement and dysarthric speech. Mentally, the patient responds very slowly but has better memory and intellect than are initially apparent.
Which of the following pathologic findings of the brain would most likely be present?
A. Depigmentation of the substantia nigra and locus ceruleus
B. Diffuse cortical atrophy with relative sparing of primary motor and sensory areas
C. Selective frontal and temporal lobe atrophy
D. Striking degeneration of the caudate nucleus
E. Widespread neuronal loss and gliosis in subcortical sites
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| PGI2alpha
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it is classical of progressive supranuclear palsy....dunno the site of the lesion
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| paheli
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C? methinks
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| CocaCola
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A???
Parkinson disease with supranuclear palsy...
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| deja_vu
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?? Progressive Supranuclear Palsy.[one of parkinson+syndrome]
- Verticle gaze paresis, akinesia& rigidity
- Tremors rarely seen.
Ans: E. Widespread neuronal loss and gliosis in subcortical sites ??
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| SURVIVOR
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toughie! E?
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| hope4dabest
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Its progressive supranuclear palsy....E???
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| new_n_lost
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deja_vu wrote:
?? Progressive Supranuclear Palsy.[one of parkinson+syndrome]
- Verticle gaze paresis, akinesia& rigidity
- Tremors rarely seen.
Ans: E. Widespread neuronal loss and gliosis in subcortical sites ??
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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The correct answer is E.
The disease is progressive supranuclear palsy, a degenerative disorder characterized by ophthalmoplegia, pseudobulbar palsy, axial dystonia, and bradykinesia. The presentation described in the question is typical. The pathologic changes consist of widespread neuronal loss and gliosis in subcortical sites with sparing of the cerebral and cerebellar cortices.
Pigmented neurons in the substantia nigra (pars compacta) and locus ceruleus (choice A) selectively degenerate in Parkinson's disease.
In Alzheimer's disease, there is diffuse cortical atrophy (choice B), especially over the association cortex of frontal, temporal, and parietal lobes, with relative sparing of primary sensory and motor areas.
Selective frontal and temporal lobe atrophy (choice C) is characteristic of Pick's disease.
The caudate nucleus and putamen undergo severe atrophy (choice D) in Huntington's disease. Cortical atrophy occurs to a lesser extent.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| paheli
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thanks
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Prepare as if you're the worst, Perform as if you're the best! As you dream, so you manifest. So, DREAM BIG!! When you face hardship, remember, God never gives you more than you can handle. Keep your face to the sunshine and you cannot see the shadows.
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| jean robert
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good one, nnl
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