Confusion/Memory Loss

Question 1

The D’s for Ddx of confusion/memory loss

Answer 1

Dementia (Vascular Dementia - stepwise decline)
Dz - Alzheimer
Depression
Deficiency - vit B12
Drugs

Question 2

The N’s for Ddx of confusion/memory loss

Answer 2

normal pressure hydrocephalus

neurosyphilis

Question 3

Ddx for AMS that i normally dont think about

Answer 3

hypothyroidism

Question 4

and always remember to put in masses and bleeds for confuison/memory loss…such as?

Answer 4

intracranial neoplasm

chronic SAH

Question 5

LIP for confusion/memory loss workup

Answer 5

Labs

• cbc
• VDRL/RPR
• TSH
• vit B12

Images

• CT head
• MRI brain

Procedures
- LP

Question 6

72 yo M — memory loss – gait disturbance (ataxia) – urinary incontinence

Answer 6

normal pressure hydrocephalus

Question 7

55 yo M – rapidly progressive change in mental status – inability to concentrate – memory impairment x 2 months – assoc symptoms include myoclonus and ataxia

Dx?
Other Ddx (name three main ones)

Answer 7

creutzfeldt-jakob dz

• lewy body dementia
• wernkicke encephalopathy
• normal pressure hydrocephalus
• along with the other AMS ddx

Question 8

70 yo insluin-dependent diabetic M with episodes of confusion, dizziness, palpitations, diaphoresis, weakness

Main Dx?
- name two neuro’s, two CV ddx

Answer 8

Main: Hypoglycemia –> get Glucose

Ddx

• Neuro: delirium, TIA –> MRI brain and carotid doppler
• CV: arrythmia, angina –> get Echo and EKG

Question 9

Specifiic workup for hypoglycemia

Answer 9

Glucose, electrolytes

Question 10

55 yo F – gradual AMS + HA – slipped and hit head – lost consciousness for 2 minutes

Main dx?
Other Ddx?

Answer 10

Subdural Hematoma

Ddx

• SIADH (causing hyponatremia)
• creutzfeldt-jakob
• intracranial neoplasm