Neuro patho 1

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Neuro patho 1

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jean robert
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12/27/07 - 10:26 PM

A 72 y.o. XX has experienced progressive memory problems for several years. For the past year, she has gotten lost while walking around her own neighborhood and has been unable to find her way home. Lately she has been unable to find the bathroom in her own house and she cannot recognize family members. Examination of her brain would most likely reveal

a) Many Lewy bodies in the substantia nigra

b) Atrophy and gliosis of the caudate nuclei

c) Neocortical neuronal Pick bodies

d) Oligodendroglial cytoplasmic inclusions

e) Numerous neocortical senile plaques

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drgho
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12/28/07 - 12:43 AM

E. Alzheimer's disease.

FromEuropeToUsa
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12/28/07 - 09:22 AM

angel23
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12/28/07 - 09:23 AM

E alziemerz ds

Tiff
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12/28/07 - 10:16 AM

Amyloid neocortical senile plaques - Alzheimer's - Choice E

new_n_lost
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12/28/07 - 05:42 PM

a) Many Lewy bodies in the substantia nigra >> Parkinsonism
b) Atrophy and gliosis of the caudate nuclei >> huntington's disease
c) Neocortical neuronal Pick bodies >> Pick's Disease
d) Oligodendroglial cytoplasmic inclusions >> Had to search this one its in MSA
e) Numerous neocortical senile plaques >> Alzheimer's Disease

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SURVIVOR
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12/29/07 - 02:19 AM

isnt E senile dementia? I would have said C. What's the answer? It isnt normal for a 72 year old lady to stop remembering her family members! The two best reasons could have been Alzheimer's or Pick's. This question has Pick's in the asnwer options. It doesnt have Alzheimer's. (E= Senile dementia)

Thats my 1 cent sticking out tongue

Tiff
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12/29/07 - 10:09 AM

Alzheimer's is a form of senile dementia.

new_n_lost
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12/29/07 - 11:09 AM

SURVIVOR wrote:
isnt E senile dementia? I would have said C. What's the answer? It isnt normal for a 72 year old lady to stop remembering her family members! The two best reasons could have been Alzheimer's or Pick's. This question has Pick's in the asnwer options. It doesnt have Alzheimer's. (E= Senile dementia)

Thats my 1 cent sticking out tongue

Picks's Disease hmmm Nah you are missing the point.

The Question describes a FEMALE with progressive dementia over the past several years. Picks is defined by a usually a male with a 6yrs span of th edisease course. The progressive loss of memory is also accompanied by early onset behaviour changes.

And i m suprised that you have missed Alzheimers in the question and in the choices. Goljan as usual says it all on pg 582-584

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jean robert
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12/30/07 - 04:15 PM

#10

Correct answer: E

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cirus
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01/01/08 - 11:58 AM

#11

new_n_lost wrote:
a) Many Lewy bodies in the substantia nigra >> Parkinsonism

its not parkison its lewy body dementia

for the qs, the ans is E

Tiff
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01/01/08 - 01:04 PM

#12

What? Lewy bodies are present in Parkinson's...and can be found in substantia nigra. They are also in Lewy body dementia. Choice A (although not correct for this question) should be referring either to Parkinson's or Lewy body dementia. Lewy bodies in substantia nigra does not distinguish Parkinsons from Lewy body dementia.

cirus
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01/02/08 - 03:27 AM

#13

lewy bodies are round deposits which contain damaged nerve cells, they are charactaristics of Lewy body dementia, not parkinsonism which is charactarized by senile plaques..

new_n_lost
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01/02/08 - 04:07 AM

#14

cirus wrote:
lewy bodies are round deposits which contain damaged nerve cells, they are charactaristics of Lewy body dementia, not parkinsonism which is charactarized by senile plaques..

Are you sure and also can you quote a reference for that please.

Because i have 2 references which say otherwise.

1. Parkinson's disease is caused by the disruption of dopaminergic neurotransmission in the basal ganglia. On pathological examination, the dopaminergic neurons in the substantia nigra are markedly reduced, and Lewy bodies (cytoplasmic inclusions) are present in the residual dopaminergic neurons.

Ref http://content.nejm.org/cgi/content/full/353/10/1...

2. Pathology
Gross pathologic examination of the brain in PD reveals mild frontal atrophywith loss of the normal dark melanin pigment of the midbrain. Microscopically there is degeneration of the dopaminergic cells with the presence of Lewybodies (LBs) in the remaining neurons and processes of the substantia nigra pars compacta (SNpc), other brainstem nuclei, and regions such as the medial temporal, limbic, and frontal cortices. LBs have a high concentration of hallmark of the disorder. Mutations in the -synuclein gene can cause familial PD bypromoting the formation of -synuclein-positive filaments that aggregate into LBs and Lewy neurites (Fig. 351-2) Ref Harrison Int Med pg 2409 Ed 16th.

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Tiff
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01/02/08 - 07:03 AM

#15

Here's an excerpt from the following article link:

http://www.emedicine.com/neuro/topic91.htm

"Postmortem examinations in both PD (Parkinson's Disease) and DLB (Dementia sith Lewy Bodies) patients demonstrate LBs in the substantia nigra and possibly in the locus ceruleus, dorsal raphe, substantia innominata, and dorsal motor nucleus of the vagus. LBs are found in the neocortex of many patients with idiopathic PD and in all patients with DLB. DLB overlaps parkinsonian dementias."

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