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Retired NBME 24 Answers

nbme24/Block 4/Question#29 (reveal difficulty score)
A 56-year-old man has a 3-year history of ...
Presenilin ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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 +28  upvote downvote
submitted by โˆ—neonem(629)
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Per Pathoma: early inherited cases of Alzheimer's dementia are associated with mutations in presenilin-1/presenilin-2, as well as Down's syndrome. Down's would be due to an extra chromosome 21, which carries the gene for amyloid precursor protein (APP). Extra APP is converted to A-beta amyloid and this forms extracellular neuritic plaques, a prominent feature of Alzehimer's.

Important to not confuse Amyloid A protein (one of the answer choices) with Amyloid precursor protein. Deposition of AA amyloid is more associated with chronic inflammatory states, malignancy, and Familial Mediterranean Fever. Beta-2 microglobulin is another amyloid association: dialysis-associated (deposits in joints)

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ih8payingfordis  Amyloidosis: FA 2019 pg 212 Alzheimer disease: FA 2019 pg 508 +



 +10  upvote downvote
submitted by โˆ—yotsubato(1208)
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Amyloid A : seen in chronic inflammatory conditions, deposition of amyloid in tissues

B2 microglobulin: associated with ESRD and long term dialysis

Neurofilament protein: Form the cytoskeleton of neurons (in healthy individuals)

Presenilin: associated with familial alzheimers disease

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sunshinesweetheart  neurofilament also seen in neuronal tumors i.e. neuroblastoma +



 +6  upvote downvote
submitted by โˆ—overa(28)
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Presenilin... think "PREmature SENILE" for early-onset Alzheimerโ€™s

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an_improved_me  Gold!! +1
jaramaiha  Also the fact that presenilin was the only option there that gives familiar Alzheimer's. definitely know which ones run in families and which are sporadic/reduced. FA20 Pg 520 +



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