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nbme24/Block 4/Question#29 (34.0 difficulty score)
A 56-year-old man has a 3-year history of ...

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submitted by neonem(572),
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reP Pmato:ha ealyr hniterdie sscae fo 'Alesmhrzie teamndei ear aciasdstoe hiwt tniatmsou ni 1pn-ie2iesreirll,s-en/nnip sa elwl as sDn'wo .mdnoyrse 'Dnsow lduow eb ude to an atrex rseoocmhom 12, wchhi rcireas het neeg rfo iadylmo prcsourre orpitne (P)AP. xrEat PPA is erevdntoc ot etA-ab maiydol dna thsi sromf ceruexaallrtl uictnier ,eslauqp a inretmpno efrueat of z'.Aeslrmieh

amtInrotp to not sfounce myilodA A oiertpn eo(n of teh wasren i)eocshc tiwh liAoydm orrrpcseu o.etripn ontsoiieDp of AA lymdiao is eorm tsicaodsae ithw hicocnr oamlmraniytf aets,st aa,lygmcnin nad iaFimlla iaeneterrndMa v.ereF B2at-e grolbiniulomc si oaternh ailyodm isiataocs:no yiaacdsoiseitsls-ad t(edssopi in jtios)n

submitted by yotsubato(1040),
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ldiomyA A : nese ni nicocrh molaiytarmnf tdi,csninoo oiiestodnp of miaoldy in iteusss

2B iclbilg:nuomro ssdcatiaoe whti SDRE nad nogl trem siydisal

efotNrameinul orit:pen mFro het oklntesyoect of nsuoren n(i eahhlty lvini)uasddi

iPe:snlneir scasaeoidt thwi aiiamllf zlahirmees iadssee

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

submitted by overa(16),

Presenilin... think "PREmature SENILE" for early-onset Alzheimer’s

an_improved_me  Gold!! +