Mimics and Maybes
Tests and Images
Name that Drug!
Pathophysiology
100

This reversible cause of dementia initially presents with lower extremity paresthesias and may be caused by metformin, gastrectomy, or pernicious anemia.

What is Vitamin B12 deficiency?

100

Virchow-Robin spaces are less detectable in patients with Alzheimers, True or False? 

What is False? 
100

This general category of medication should be initiated for patients with dementia and depression.

What are anti-depressants?

100

What do Tau Proteins aggregate into in Alzheimer's Disease?

Neurofibrillary Tangles

200

This second most common cause of dementia in the elderly presents on MRI or CT with multiple cortical or subcortical infarcts.

What is vascular dementia?

200

Name three of the four domains measured by the Folstein test. 

What is: 

  • Complex attention (e.g., sustained attention, divided attention, selective attention, and processing speed)

  • Language  

  • Learning and memory (e.g., object naming, word-finding, fluency, grammar, semantics) 

  • Orientation to person, place, and time 

200

This class of medication is used to treat symptoms of Alzheimer's and includes Donepezil, Rivastigmine, and Galantamine.

What are cholinesterase inhibitors?

200
What causes Tau proteins to lose their microtubule-stabilizing function?

Hyperphosphorylation

300

You must first rule out this common condition as a cause of the presenting dementia when diagnosing neurodegenerative disorders.

What is depression aka pseudodementia?

300

What can GDS be used to diagnose? (be specific)

What is MDD (Major depressive disorder)? 

300

This drug helps prevent excitotoxicity mediated by Ca2+ in Alzheimer's disease.

What is memantine?

300

What part of the brain do plaques usually form in first?

Hippocampus

400

This reversible cause of dementia presents with urinary incontinence.

What is normal pressure hydrocephalus?

400

A 72-year-old woman is brought to her primary care physician due to increasing confusion. Her daughter explains that her mother has grown increasingly impaired and agitated over the past 2 years. She forgets where she puts items, gets lost while driving, and has become suspicious that her grandchildren are stealing from her. Physical examination is normal.

Which of the following is the most likely pathologic finding in this patient?

A. Atrophy of the caudate and putamen

B. Degeneration of dopaminergic neurons within the substantia nigra 

C. Enhancing lesions in the temporal lobe 

D. Increased serum amyloid A proteins 

E. Atrophy of amydala and parahippocampal gyrus

What is E. Atrophy of amydala and parahippocampal gyrus? 

This patient presents with increasing confusion, memory deficits, and agitation. She most likely has Alzheimer disease, a chronic, progressive, global decline in multiple cognitive areas. It is the most common cause of dementia in the United States. It initially presents with memory deficits. Over time, language deficits, depression, agitation, apraxia, and agnosia may develop.

  • Atrophy of the caudate and putamen is seen in Huntington disease, which presents with chorea and altered behavior.
  • Degeneration of dopaminergic neurons in the substantia nigra is the cause of Parkinson disease, which presents with resting tremor, rigidity, and postural instability with a shuffling gait.
  • Increased serum amyloid A proteins are associated with systemic inflammation, not dementia.
  • Enhancing lesions in the temporal lobe are seen in herpes simplex virus encephalitis, which presents with fever, headache, and altered mental status. 
400

This receptor of glutamate plays an important role in memory formation and may be targeted in Alzheimer's drug therapy.

What is the N-methyl-D-aspartate (NMDA) receptor?

400

List three functions of Acetylcholine

Learning, memory, motor control, attention, arousal, modulation of sensory info, regulation of mood

500

Presenting decades after the initial inciting event, this reversible cause of dementia may present with Argyll Robertson pupils.

What is neurosyphilis?

500

Name the specific areas of mesial (aka medial) temporal lobe atrophy in patients with Alzheimers.

What is hippocampus, entorhinal cortex and perirhinal cortex? 

500

This interaction between two or more commonly prescribed Alzheimer's drugs causes the total effect of the drugs to be greater than the sum of their individual effects.

What is synergy?

500

A biopsy of a brain with Alzheimer's will show what histological feature related to neurofibrillary tangles?

Flame-shaped basophilic inclusions around a single nucleus

M
e
n
u