Pharmacology · patient case question
Which neurochemical is most associated with this patient's condition?
Patient case: Elderly man with Alzheimer disease and a symptomatic upper left molar
Patient: Male, 78 years old
Chief complaint: “His tooth has been hurting him and his face is swollen.” Reported by the wife, who accompanies him.
Background: Alzheimer disease, moderate stage. Medication: donepezil. His wife attends every appointment and manages his daily care.
Current findings: Periapical radiograph shows tooth #15 lying on its side (slanted/impacted) with an associated radiolucency. Swelling and pain localised to #15. Patient is pleasantly confused and defers all questions to his wife.
Show answer and explanation
Correct answer: C. Acetylcholine
- A. Prostaglandins are inflammatory mediators — the target of NSAIDs, unrelated to dementia.
- B. Nucleotides are nucleic acid building blocks, with no role in this disease.
- C. CORRECT. Alzheimer disease features degeneration of cholinergic neurons (notably the nucleus basalis of Meynert), producing an ACETYLCHOLINE deficit. This is precisely why his donepezil was prescribed.
- D. Choline is the dietary precursor for acetylcholine synthesis, but the implicated neurotransmitter itself is acetylcholine.