American Board of Internal Medicine (ABIM) Certification Practice Exam

What symptom combination would suggest sporadic Creutzfeldt-Jakob disease?

1. Memory loss and fatigue

2. Ataxia, spasticity, myoclonus, and cognitive decline

3. Visual impairment and seizures

4. Respiratory distress and fever

The correct answer is: Ataxia, spasticity, myoclonus, and cognitive decline

Sporadic Creutzfeldt-Jakob disease (sCJD) is a rapidly progressive neurodegenerative disorder characterized by a specific combination of symptoms that reflect its impact on the nervous system. The symptom combination that suggests sCJD typically includes ataxia, spasticity, myoclonus, and cognitive decline. Ataxia refers to a lack of muscle coordination, which can affect gait and movement. Spasticity involves increased muscle tone and stiffness, often resulting from upper motor neuron lesions. Myoclonus is the occurrence of brief, involuntary muscle jerks, a hallmark symptom in many prion diseases. Cognitive decline, which may manifest as memory loss, confusion, or other cognitive impairments, is commonly observed as the condition progresses. Collectively, these symptoms represent the neurological decline associated with sCJD and help clinicians make a differential diagnosis when evaluating a patient with rapidly progressive dementia. The other combinations of symptoms provided do not align with the typical presentation of sCJD. For example, memory loss and fatigue might occur in a range of neurological or psychiatric conditions, while visual impairment and seizures are more indicative of other neurological disorders. Respiratory distress and fever are nonspecific and usually suggest common illnesses or infections rather