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Retired NBME 20 Answers

nbme20/Block 1/Question#9 (reveal difficulty score)
A 50-year-old man is brought to the physician ...
Pick disease ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: biochem

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 +9  upvote downvote
submitted by โˆ—hayayah(1212)
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Frontotemporal dementia (formerly known as Pick disease): Early changes in personality and behavior (behavioral variant), or aphasia (primary progressive aphasia). May have associated movement disorders (eg, parkinsonism).

While this presents very similiarly to Hungtington's, you can differentiate it because in this stem it says "atrophy of the frontal lobes bilaterally" whereas Huntington's has atrophy of caudate and putamen with ex vacuo ventriculomegaly.

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dickass  and the patient has no chorea +6
chj7  Also, in frontotemporal dementia, due to disease of the "cortex", memory/speech/behavioural changes occur early on. (In Pathoma at the beginning of the dementia lecture, he emphasizes distinguishing between disorders of the cortex vs. disorders of the striatum (ie. Huntington's & Parkinson's) as clinical presentations are easily separated.) +1



 +3  upvote downvote
submitted by โˆ—strugglebus(189)
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Fronto-temporal dementia characterized by personality change is usually Picks

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 +3  upvote downvote
submitted by โˆ—thecatguy(19)
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Classic NBME BS:

  • C gives the dated term with the contemporary term in parentheses
  • E only gives the dated term

So the examiner is acknowledging that they're not just living in the past, but they're also just a straight up a-hole

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longhairdontcare  AMEN! +
len49  Lol if they gave the modern name, it would be too easy I guess. +



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