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14 Cards in this Set
- Front
- Back
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Key History -
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Hx from family members/caregivers
time course of cognitive deficits associated Sxs - constitutional incontinence ataxia hypothyroid Sxs depression screen for delirium - waxing/waning level of alertness ADL/IADL staus falls meds & recent med changes h/o stroke atherosclerotic vascular dis. syphilis HIV risk factors alcohol use vitamn B12 deficiency family h/o Alzheimer's |
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Key PE -
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VS
complete neuro exam - include mini-mental & gait ENT heart lungs abdomen extremities |
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81 y/o M
presents with progressive confusion over the past several years together with forgetfulness and clumsiness. He has a h/o HTN, DM and 2 strokes with residual left hemiparesis. Mental status has clearly worsened after each stroke. What is Differential? |
Vascular ("multi-infarct") dementia
alzheimer's normal pressure hydrocephalus chronic subdural hematoma intracranial tumor depression B12 deficiency neurosyphilis hypothyroidism |
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81 y/o M
presents with progressive confusion over the past several years together with forgetfulness and clumsiness. He has a h/o HTN, DM and 2 strokes with residual left hemiparesis. Mental status has clearly worsened after each stroke. What is Workup? |
CBC
RPR/VDRL serum B12 TSH MRI - brain CT - head LP - CSF analysis |
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84 y/o F
brought by her son c/o forgetfulness (e.g., forgets phone nos., loses her way back home) along with difficulty performing some of her daily activities (e.g., bathing, dressing, managing money, using the phone). The problem has gradually progressed over the past few years. What is Differential? |
Alzheimer's
vascular dementia depression hypothyroidism chronic subdural hematoma normal pressure hydrocephalus intracranial tumor B12 deficiency neurosyphilis |
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84 y/o F
brought by her son c/o forgetfulness (e.g., forgets phone nos., loses her way back home) along with difficulty performing some of her daily activities (e.g., bathing, dressing, managing money, using the phone). The problem has gradually progressed over the past few years. What is Workup? |
CBC
RPR/VDRL serum B12 TSH MRI - brain CT - head LP - CSF analysis |
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72 y/o M
presents with memory loss, gait disturbance and urinary incontinence for the past six months. What is Differential? |
Normal pressure hydrocephalus
alzheimer's vascular dementia chronic subdural hematoma intracranial tumor depression B12 deficiency neurosyphilis hypothyroidism |
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72 y/o M
presents with memory loss, gait disturbance and urinary incontinence for the past six months. What is Workup? |
CT - head
LP - opening pressure and CSF analysis serum B12 RPR/VDRL TSH |
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55 y/o M
presents with a rapidly progressive change in mental status, inability to concentrate and memory impairment for the past 2 mos. His Sxs are associated with myoclonus and ataxia. What is Differential? |
Creutzfeldt-Jakob disease
vascular dementia lewy body dementia wernicke's encephalopathy normal pressure hydrocephalus chronic subdural hematoma intracranial tumor depression delirium B12 deficiency neurosyphilis |
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55 y/o M
presents with a rapidly progressive change in mental status, inability to concentrate and memory impairment for the past 2 mos. His Sxs are associated with myoclonus and ataxia. What is Workup? |
CBC, electrolytes, calcium
serum B12 RPR/VDRL MRI - brain (preferred) CT - head EEG LP - CSF analysis brain Bx |
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70 y/o IDDM M
presents with episodes of confusion, dizziness, palpitation, diaphoresis and weakness. What is Differential? |
Hypoglycemia
TIA arrhythmia delirium angina |
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70 y/o IDDM M
presents with episodes of confusion, dizziness, palpitation, diaphoresis and weakness. What is Workup? |
Glucose
CBC, electrolytes echocardiography ECG MRI - brain doppler US - carotid |
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55 y/o F
presents with gradual altered mental status and headache. Two weeks ago, she slipped, hit her head on the ground and lost consciousness for two minutes. What is Differential? |
Subdural hematoma
SIADH (causing hyponatremia) creutzfeldt-jakob intracranial tumor |
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55 y/o F
presents with gradual altered mental status and headache. Two weeks ago, she slipped, hit her head on the ground and lost consciousness for two minutes. What is Workup? |
Electrolytes
CT - head MRI - brain LP |
