Creutzfeldt-Jakob Disease, Use of TPE in Dementia, Indications for Therapeutic Plasma Exchange, Ther скачать в хорошем качестве

Creutzfeldt-Jakob Disease, Use of TPE in Dementia, Indications for Therapeutic Plasma Exchange, Ther

A 43-year-old man experiences rapidly progressive memory loss, clumsiness, and stimulus-sensitive arm jerks over seven weeks, with recent disorientation and worsening neurologic signs. Neurologic exam reveals severe short-term memory impairment, myoclonus, gait ataxia, and abnormal MRI and EEG findings. What should clinicians consider when faced with rapidly declining cognitive and motor function, and how might initial diagnostic data guide further workup and management decisions? VIDEO INFO Category: Creutzfeldt-Jakob Disease, Use of TPE in Dementia, Indications for Therapeutic Plasma Exchange, Therapeutic plasma exchange, Clinical Pathology Difficulty: Easy - Basic level - Suitable for medical students Question Type: Natural History Case Type: Common Scenario Explore more ways to learn on this and other topics by going to https://endlessmedical.academy/auth?h... QUESTION A 43-year-old man is brought by his partner for 7 weeks of very fast memory loss, clumsiness, and sudden arm jerks set off by sounds. He now knows his name but not place or date. He has gotten lost on familiar streets and has dropped utensils while eating. He denies fever, headache, or head injury. Vital signs: temperature 36.4 degreesC, heart rate 89/min, respiratory rate 12/min, blood pressure 107/69 mm Hg, oxygen saturation 97% on room air.... OPTIONS A. This is a fast and fatal brain disease. Most people die within months. There is no treatment that changes the disease. Plasma exchange does not help in prion disease. Care should focus on comfort, safety, and family support. B. Because some immune brain problems improve with blood filtering, a short trial of plasma exchange could be tried now while the team watches for any improvement and sets up home help. C. Giving intravenous immune globulin and then plasma exchange can remove bad proteins from blood and has been shown to prolong life in prion dementia; it should be started once the EEG shows sharp waves. D. Urgent plasma exchange will clear prions from the blood, lower spread risk, and slow the disease; further exchanges can be spaced out if he seems to respond. CORRECT ANSWER A. This is a fast and fatal brain disease. Most people die within months. There is no treatment that changes the disease. Plasma exchange does not help in prion disease. Care should focus on comfort, safety, and family support. EXPLANATION The clinical picture is classic for sporadic Creutzfeldt-Jakob disease: weeks of rapidly progressive cognitive decline, stimulus-sensitive myoclonus, ataxia, and supportive tests including cortical ribboning with basal ganglia diffusion changes on MRI, periodic sharp-wave complexes on EEG, and positive CSF RT-QuIC. This illness is caused by misfolded prion protein that propagates within the central nervous system. Per the 2024 Centers for Disease Control and Prevention clinical overview and prognosis pages, the natural course is relentlessly progressive, with most patients dying within months of symptom onset. There is no disease-modifying therapy. Per the 2023 American Society for Apheresis guideline, therapeutic plasma exchange is not an indication in prion disease and should not be offered as a disease-modifying measure. --------------------------------------------------- Our cases and questions come from the https://EndlessMedical.Academy quiz engine - multi-model platform. Each question and explanation is forged by consensus between multiple top AI models (GPT, Claude, Grok, etc.), with automated web searches for the latest research and verified references. Calculations (e.g. eGFR, dosages) are checked via code execution to eliminate errors, and all references are reviewed by several AIs to minimize hallucinations. Important note: This material is entirely AI-generated and has not been verified by human experts; despite stringent consensus checks, perfect accuracy cannot be guaranteed. Exercise caution - always corroborate the content with trusted references or qualified professionals, and never apply information from this book to patient care or clinical decisions without independent verification. Clinicians already rely on AI and online tools - myself included - so treat this book as an additional focused aid, not a replacement for proper medical education. Visit https://endlessmedical.academy for more AI-supported resources and cases. This material can not be treated as medical advice. May contain errors. ---------------------------------------------------