A 71-year-old woman is brought to the physician by her daughter. She says that her mother went shopping yesterday and could not find her way back home. Two years ago, her mother "started forgetting things like where she put her keys" and "began to have problems remembering the right words." Now she has trouble keeping up with her activities of daily living and refuses to pay her bills because "it's a waste of money." The patient's past medical history is unremarkable. Brain magnetic resonance imaging (MRI) is most likely to show atrophy of which of the following structures?

Question

A 71-year-old woman is brought to the physician by her daughter.  She says that her mother went shopping yesterday and could not find her way back home.  Two years ago, her mother "started forgetting things like where she put her keys" and "began to have problems remembering the right words."  Now she has trouble keeping up with her activities of daily living and refuses to pay her bills because "it's a waste of money."  The patient's past medical history is unremarkable.  Brain magnetic resonance imaging (MRI) is most likely to show atrophy of which of the following structures?

Quizplus · Accepted Answer

11ec160b_39a9_2407_9249_9fa7d4567980_MD0001_00 11ec160b_39a9_2408_9249_914cac871501_MD0001_00 Alzheimer's disease is a neurodegenerative disorder that presents with insidiously progressive memory loss. It is the most common cause of dementia and usually affects people > 60 years of age. Language deficits (word-finding difficulty) and impaired visuospatial ability (misplacement of items) can occur early in the course of the disease. Later, as impairment in executive function and associated behavioral abnormalities become more pronounced, patients can have trouble performing everyday functions (eg, shopping, cooking, and managing money). Advanced Alzheimer's disease is associated with diffuse brain atrophy. Atrophy is most pronounced in the temporoparietal lobes and hippocampus. Hippocampal atrophy is evident even in the early stages of the disease and can be detected by brain MRI. The cerebellum (Choice B), corpus callosum (Choice C), pons (Choice D), and thalamus (Choice E) are not obviously atrophied in Alzheimer's disease. Educational objective: The hippocampus is the area of the brain demonstrating the greatest degree of atrophy in Alzheimer's disease. Hippocampal atrophy on MRI is highly suggestive of the diagnosis.

A 71-Year-Old Woman Is Brought to the Physician by Her