A 66-year-old man presents with rapidly progressive dementia, myoclonic jerks, and gait ataxia over 4 months. Vital signs: BP 138/82, HR 88, RR 16, Temp 37.2°C, SpO2 98%. Neurologic exam shows cogwheel rigidity and hyperreflexia; no focal weakness. EEG demonstrates periodic sharp-wave complexes. MRI reveals cortical ribboning and basal ganglia atrophy. CSF 14-3-3 protein is elevated. Which of the following best explains the underlying pathophysiology of this patient's condition?

  1. A)Intracellular accumulation of alpha synuclein in cortical neurons
  2. B)Loss of cholinergic neurons in the basal forebrain
  3. C)Expansion of a CAG trinucleotide repeat on chromosome 4
  4. D)Autoimmune antibodies to postsynaptic NMDA receptors
  5. E)Accumulation of a misfolded protein that converts normal proteins into beta pleated sheetsGABARITO

Explicação

Accumulation of a misfolded protein that converts normal proteins into beta pleated sheets is correct. Creutzfeldt Jakob disease is a prion disease characterized by rapidly progressive dementia, myoclonus, ataxia, and periodic sharp waves on EEG. Pathology sho... Ver explicação completa e trilha adaptativa →

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