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ChapterPathology Neuropathology

Neurodegenerative diseases

Free notes, MCQs, tables & flowcharts for USMLE Step 1 Pathology

10Questions
10Flashcards
1Tables & Flowcharts

Sample Questions

1

An 81-year-old man is brought to the physician by his daughter after he was found wandering on the street. For the last 3 months, he often has a blank stare for several minutes. He also claims to have seen strangers in the house on several occasions who were not present. He has hypertension and hyperlipidemia, and was diagnosed with Parkinson disease 8 months ago. His current medications include carbidopa-levodopa, hydrochlorothiazide, and atorvastatin. His blood pressure is 150/85 mm Hg. He has short-term memory deficits and appears confused and disheveled. Examination shows bilateral muscle rigidity and resting tremor in his upper extremities. He has a slow gait with short steps. Microscopic examination of the cortex of a patient with the same condition is shown. Which of the following is the most likely diagnosis?

AVascular dementia

BLewy body dementia

CCreutzfeldt-Jakob disease

DNormal pressure hydrocephalus

EFrontotemporal dementia

2

An 80-year-old woman is brought to the physician by her 2 daughters for worsening memory loss. They report that their mother is increasingly forgetful about recent conversations and events. She is unable to remember her appointments and commitments she has made. 3 years ago, the patient was moved into an elder care facility because she was often getting lost on her way home and forgetting to take her medications. The patient reports that she is very socially active at her new home and has long conversations with the other residents about her adventures as an air hostess during her youth. Which of the following cerebral pathologies is most likely present in this patient?

ALewy bodies

BLacunar infarcts

CIntracytoplasmic vacuoles

DNeurofibrillary tangles

EDemyelination

3

A 70-year-old woman is brought to the office after her nurse noticed her being apathetic, easily distracted, and starting to urinate in bed. Her medical history is relevant for hypertension, under control with medication. Physical examination reveals a blood pressure of 138/76 mm Hg, a heart rate of 70/min, and a respiratory rate 14/min and regular. On neurological examination, she has a broad-based shuffling gait, and increased muscle tone in her limbs that is reduced by distracting the patient. There is decreased coordination with exaggerated deep tendon reflexes, decreased attention and concentration, and postural tremor. Which of the following additional features would be expected to find in this patient?

ADegeneration of the substantia nigra pars compacta

BCaudate head atrophy

CAccumulation of Lewy bodies in cortical cells

DDilation of the ventricular system

EAccumulation of amyloid plaques and neurofibrillary tangles in the cerebral cortex

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