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NBME 18 Answers

nbme18/Block 1/Question#11 (8.7 difficulty score)
67 yo man, fine resting tremor in both hands

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I was confused between Alpha- Synuclein and Tau. This patient has parkinsons diseases and thus we would see Alpha synuclein.

Tau is seen in patients with Picks disease, aka Frontotemporla dementia AND alzheimers disease. page 504. FA 2018

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submitted by andro(109),

Intracellular aggregates in neurodegenerative conditions :

Alpha synuclein- a protein mainly found in terminal axons which can aggregate and deposit intracellularly to form Lewy Bodies . These are associated with the neurodegenerative conditions 1. Parkinsons Disease 2. Lewy Body Dementia

Neurofibrillary tangles - hyperphosphorylated tau protein , number of tangles correlates with degree of dementia

Pick bodies - hyperphosphorylated tau . these are round aggregates though in contrast to neurofibrillary tangles. Seen in Frontotemporal dementia and other neurodegenerative conditions

Hirano bodies - intracellular aggregates of damaged actin filaments seen in various neurodegenerative conditions e.g AZ , ALS , Creutzfeldt-jakob Disease ( These are not really tested on )