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Free notes, MCQs, tables & flowcharts for USMLE Step 1 Pathology
A 73-year-old man is brought to the physician by his daughter for evaluation of increasing forgetfulness during the past 6 months. The daughter reports that he recently got lost while walking home from the grocery store. He has also been more irritable recently. On mental status examination, he has a normal affect. He is oriented to person and place but cannot recall which month it is. He recalls memories from more than 20 years ago in great detail but cannot state his home address or the name of his recently born grandson. His gait is normal and there is no nystagmus. An MRI of the brain is shown. Which of the following is the most likely underlying cause of the radiologic findings?
ADemyelination of periventricular structures
BBleeding into the ventricular system
CObstruction of the foramen of Monro
DInflammation of the choroid plexus
EAtrophy of the cortex
A 70-year-old man with a long-standing history of diabetes mellitus type 2 and hypertension presents with complaints of constant wrist and shoulder pain. Currently, the patient undergoes hemodialysis 2 to 3 times a week and is on the transplant list for a kidney. The patient denies any recent traumas. Which of the following proteins is likely to be increased in his plasma, causing the patient’s late complaints?
AAmyloid precursor protein
BAmyloid A (AA)
Cβ2-microglobulin
DTransthyretin (TTR)
EIg light chains
A 45-year-old man is brought to the hospital by his daughter with complaints of wide-based gait. His daughter reveals that he was sitting silently in the examination chair with a blank face. In addition, he was frequently talking to the empty chairs and told that his friends are sitting there. He has been forgetting many small things recently. On physical examination, fine movements are seen at resting condition that disappears when he is asked to drink water. A stepwise slowness in movement is also seen in his upper limb. Which of the following is most likely to be observed in the histological specimen of this patient?
ASpongiform changes in cortex
BNeuritic plaques in cortex
CLewy bodies in affected neurons
DTau protein aggregates in cortex
ENeurofibrillary tangles in hippocampus
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