Question
A 76-year-old man is admitted to the hospital for evaluation of progressive memory loss and disorientation. The pupils are small but react normally to light. Muscle tone is normal. A lumbar puncture returns clear, colorless CSF under normal pressure. An electroencephalogram shows diffuse slowing. A CT scan of the brain reveals moderate atrophy. Which of the following is the most likely diagnosis?
| A. |
Alzheimer disease
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| B. |
Creutzfeldt-Jakob disease
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| C. |
Glioblastoma multiforme
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| D. |
Huntington disease
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Show Answer
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Correct Answer � A
Explanation
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Answer: A Alzheimer disease
Alzheimer disease is the most common cause of dementia in the elderly, accounting for more than half of all cases.
Alzheimer’s original patients were younger than 65 years of age, but the disease now refers to dementias that display characteristic pathologic findings.
Alzheimer disease is an insidious and progressive neurologic disorder, characterized clinically by loss of memory, cognitive impairment, difficulty with language, and eventual dementia.
It features atrophy of the brain, which can be recognized by CT scan as widening of the sulci and bilateral atrophy of the gyri, particularly the frontal and hippocampal cortex.
These clinical and morphologic features are not typically observed in the other choices. Bronchopneumonia is the usual lethal outcome of Alzheimer disease.
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