Neurology: Case of the Month

Test Yourself — Patient 44

Thalamic (diencephalic) Amnesia

  1. Diencephalic structures thought to be involved in memory function include WHICH of the following:
    • [ A ] Amygdala
    • [ B ] Mammillary bodies
    • [ C ] Ventral posterolateral thalamic nuclei
    • [ D ] Dorsomedial frontal cortex
    • [ E ] More than one of the above
  2. Which of the following is MOST characteristic of a primary dementia?
    • [ A ] Selective impairment of memory, without involvement of other cognitive functions
    • [ B ] Waxing and waning (fluctuating) cortical dysfunction
    • [ C ] Rapid progression over less than two months
    • [ D ] Progression of deficits to involve multiple cognitive functions
  3. Severe verbal amnesia may result from any of the following processes, EXCEPT:
    • [ A ] Trauma involving amygdala and hippocampus bilaterally
    • [ B ] Wernicke's encephalopathy with damage to the mammillary bodies
    • [ C ] Tumor involving the flocculonodular lobe of the cerebellum
    • [ D ] Ischemic stroke involving the anterior portion of the thalamus
    • [ E ] A primary dementing process involving the temporal lobes
  4. Absence of a multifocal pattern of reduced uptake on SPECT studies can generally be taken to exclude a vascular cause of cognitive deficits.
    • [ A ] True
    • [ B ] False
  5. Which of the following statements are TRUE:
    • [ A ] A clinical response to a cholinesterase inhibitor such as donepezil increases the likelihood of a diagnosis of Alzheimer's disease.
    • [ B ] Diminished social and occupational functioning in the elderly rarely occurs in the absence of a dementing illness.
    • [ C ] The patient's history of rheumatoid arthritis (requiring nonsteroidal anti-inflammatory medication use) increases her risk of developing Alzheimer's disease.
    • [ D ] A and B
    • [ E ] None of the above

 

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