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General Medicine · Neurology: frontotemporal dementia pathology
Sample itemA 58-year-old man has progressive disinhibition, hyperorality and apathy over two years, with memory relatively preserved early on. MRI shows frontal and anterior temporal atrophy. Which pathological finding characterises one major subtype?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Pick bodies containing tau
Frontotemporal dementia presents with behavioural change, language disorder or both. Pathology includes tau-positive Pick bodies, or TDP-43 or FUS inclusions. Alzheimer disease begins with memory loss and hippocampal involvement.
Option by option
A. Pick bodies containing tau (correct)
Correct. Tau-positive Pick bodies are seen in a major subtype with frontal and temporal atrophy.
B. Hippocampal amyloid plaques with tangles predominating
Early memory loss with hippocampal changes points to Alzheimer disease.
C. Spongiform change with abnormal prion protein
Spongiform change is seen in Creutzfeldt-Jakob disease with rapid course and myoclonus.
D. Lewy bodies containing alpha-synuclein
Lewy bodies are found in Parkinson disease and dementia with Lewy bodies.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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