2 Confusion/Memory Loss Flashcards
81yo M presents with progressive confusion for the past several years accompanied by forgetfulness and clumsiness. He has a history of hypertension, diabetes mellitus, and 2 strokes with residual left hemiparesis. His mental status has worsened after each stroke (stepwise decline in cognitive function)
VASCULAR ("MULTI INFARCT") DEMENTIA
alzheimers disease
normal pressure hydrocephalus
chronic subdural hematoma
intracranial neoplasm
depression
B12 deficiency
neurosyphilis
hypothyroidism
CBC VDRL/RPR serum B12 TSH MRI brain CT head LP
84yo F brought by her son c/o forgetfulness (e.g. forgets phone numbers, loses her way back home) and difficulty performing some of her daily activities (e.g. bathing, dressing, managing money, using the phone). The problem has progressed gradually over the past few years.
ALZHEIMERS vascular dementia depression hypothyroidism chronic subdural hematoma normal pressure hydrocephalus intracanial neoplasm B12 deficiency neurosyphilis
CBC VDRL/RPR serum B12 TSH MRI brain (preferred) CT head LP
72yo M presents with memory loss, gait disturbance, and urinary incontinence for the past 6 months
NORMAL PRESSURE HYDROCEPHALUS alzheimers vascular dementia chronic subdural hematoma intracranial neoplasm depression B12 def neurosyphilis hypothyroidism
CT head MRI brain LP opening pressure and CSF analysis serum B12 VDRL/RPR TSH
55yo M presents with rapidly progressive change in mental status, inability to concentrate, and memory impairment for the past 2 months. His symptoms are associated with myoclonus, ataxia and a startle response.
CREUTZFELDT-JAKOB DISEASE vascular dementia lewy body demendia wernicke's encephalopathy normal pressure hydrocephalus chronic subdural hematoma intracranial neoplasm depression delirium B12 deficiency neurosyphilis
CBC electrolytes, calcium serum B12 VDRL/RPR MRI brain (preferred) CT head EEG LP brain biopsy
70yo insulin-dependent diabetic M presents with episodes of confusion, dizziness, palpitations, diaphoresis, and weakness.
HYPOGLYCEMIA transient ischemic attack arrhythmia delirium angina
glucose CBC electrolytes CPK-MB, troponin echocardiography ECG MRI brain Doppler U/S- carotid
55yo F presents with gradual altered mental status and headache. Two weeks ago she slipped, hither head on the ground and lost consciousness for 2 minutes.
SUBDURAL HEMATOMA
SIADH (causing hyponatremia)
creutzfeldt-jakob disease
intracranial neoplasm
CT head cbc electrolytes MRI brain LP
