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Exam Section 1: Item 1of 50National Board of Medical ExaminersTime Remaining:H MarkComprehensive Basic Science Self-Assessment3 hr 59 min 9 sec
1. A 62-year-old man is brought to the physician by his wife because of increasing confusion during the past 6 months. His wife says that he has become lost twice in the past month whengoing to work, even though he has been going to the same office for 12 years. She adds that he often has difficulty finding objects such as his glasses and keys, sometimes cannot recallhis grandchildren's names, and has become very critical of her cooking, which he used to enjoy. When asked, he can name only the current president and none of the candidates for anupcoming presidential election, although he and his wife watch the television news together each night. Neurologic examination shows no motor or sensory abnormalities. His Mini-MentalState Examination score is 19/30. Treatment with a cholinesterase inhibitor is most likely to improve this patient's memory because of its ability to target synaptic connections betweenwhich of the following structures?o A) The basal forebrain and neurons in the cerebral cortexB) The dentate nucleus and the thalamusC) The fornix and neurons in the mammillary bodiesD) The substantia nigra and the neurons of the globus pallidusO E) The thalamus and neurons in layer 4 of the cerebral cortex