01-14-2012, 07:25 AM
An 82-year-old woman is brought to the physician by her granddaughter because of a 6-week
history of increasing forgetfulness. She is a retired schoolteacher and lives independently. Her granddaughter is concerned because on several occasions she has left the stove on when she went to bed. During conversations with her granddaughter, she has difficulty remembering past events and seems unconcerned about her memory lapses. The patient describes trouble sleeping through the night and has had a decreased appetite resulting in a 4.5-kg (10-lb) weight loss over the past month. She has a history of similar symptoms 2 and 5 years ago that were successfully treated with medication. She appears unkempt and has poor personal hygiene. Her temperature is 37 C (98.6 F), blood pressure is 110/70 mm Hg, and pulse is 80/min and regular. Mental status examination shows psychomotor retardation, a flat affect, impaired ability to recall past events, and trouble repeating three numbers in sequence. She is unable to recall the names of recent presidents. Her serum urea nitrogen (BUN) level is 25 mg/dL, and serum creatinine level is 1.7 mg/dL.
For each patient with cognitive impairment, select the most likely diagnosis.
A ) Acute stress disorder
B ) Dementia, Alzheimer's type
C ) Dissociative amnesia
D ) General paresis
E ) Head trauma
F ) Hepatolenticular degeneration (Wilson's disease)
G ) HIV encephalitis
H ) Huntington's disease
I ) Major depressive disorder
J ) Multi-infarct (vascular) dementia
K ) Niacin deficiency
L ) Normal-pressure hydrocephalus
M ) Parkinson's disease
N ) Pick's disease
O ) Schizophrenia, catatonic type
P ) Normal aging
Please give explanation...enjoy!
history of increasing forgetfulness. She is a retired schoolteacher and lives independently. Her granddaughter is concerned because on several occasions she has left the stove on when she went to bed. During conversations with her granddaughter, she has difficulty remembering past events and seems unconcerned about her memory lapses. The patient describes trouble sleeping through the night and has had a decreased appetite resulting in a 4.5-kg (10-lb) weight loss over the past month. She has a history of similar symptoms 2 and 5 years ago that were successfully treated with medication. She appears unkempt and has poor personal hygiene. Her temperature is 37 C (98.6 F), blood pressure is 110/70 mm Hg, and pulse is 80/min and regular. Mental status examination shows psychomotor retardation, a flat affect, impaired ability to recall past events, and trouble repeating three numbers in sequence. She is unable to recall the names of recent presidents. Her serum urea nitrogen (BUN) level is 25 mg/dL, and serum creatinine level is 1.7 mg/dL.
For each patient with cognitive impairment, select the most likely diagnosis.
A ) Acute stress disorder
B ) Dementia, Alzheimer's type
C ) Dissociative amnesia
D ) General paresis
E ) Head trauma
F ) Hepatolenticular degeneration (Wilson's disease)
G ) HIV encephalitis
H ) Huntington's disease
I ) Major depressive disorder
J ) Multi-infarct (vascular) dementia
K ) Niacin deficiency
L ) Normal-pressure hydrocephalus
M ) Parkinson's disease
N ) Pick's disease
O ) Schizophrenia, catatonic type
P ) Normal aging
Please give explanation...enjoy!