10-31-2009, 12:55 PM
A 75-year-old male is brought to your office by his wife, who states that he has had mental
difficulties in recent months, such as not being able to balance their checkbook or plan for his
annual visit with the accountant. He was able to capably perform these activities in the past.
She also tells you that he has reported seeing animals in the room with him that he can describe
vividly. He naps for 3 or more hours each day, and stares blankly for long periods of time. He
seems almost normal at times, but appears very confused at other times. This confusion seems
to come and go randomly. He also has been dreaming a lot, and has fallen more than once
recently. His only medication is aspirin, 81 mg/day.
On examination the patient walks slowly with a somewhat stooped posture and almost falls when
turning around. He has only minimal facial expressiveness. No tremor is noted, and the
remainder of the examination is normal. He is able to recall three words out of three, but clock
drawing is abnormal. Laboratory studies are normal, and a CT of the brain shows changes of
aging.
What type of dementia does this patient most likely have?
A) Dementia with Lewy bodies
B) Dementia of Parkinson™s disease
C) Alzheimer™s disease
D) Frontotemporal dementia
E) Vascular dementia
difficulties in recent months, such as not being able to balance their checkbook or plan for his
annual visit with the accountant. He was able to capably perform these activities in the past.
She also tells you that he has reported seeing animals in the room with him that he can describe
vividly. He naps for 3 or more hours each day, and stares blankly for long periods of time. He
seems almost normal at times, but appears very confused at other times. This confusion seems
to come and go randomly. He also has been dreaming a lot, and has fallen more than once
recently. His only medication is aspirin, 81 mg/day.
On examination the patient walks slowly with a somewhat stooped posture and almost falls when
turning around. He has only minimal facial expressiveness. No tremor is noted, and the
remainder of the examination is normal. He is able to recall three words out of three, but clock
drawing is abnormal. Laboratory studies are normal, and a CT of the brain shows changes of
aging.
What type of dementia does this patient most likely have?
A) Dementia with Lewy bodies
B) Dementia of Parkinson™s disease
C) Alzheimer™s disease
D) Frontotemporal dementia
E) Vascular dementia