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First Aid: Step 2 CS > Differential & Work-up: Confusion/Memory Loss > Flashcards

Differential & Work-up: Confusion/Memory Loss Flashcards

1
Q

81 yo M presents with progressive confusion for the past several years accompanied by forgetfulness and clumsiness. He has a history of hypertension, diabetes mellitus, and two strokes with residual left hemiparesis. His mental status has worsened after each stroke (stepwise decline in cognitive function).

A
  1. Vascular (“multiinfarct”) dementia
  2. Alzheimer disease
  3. Normal pressure hydrocephalus
  4. Chronic subdural hematoma
  5. Intracranial neoplasm
  6. Depression
  7. B12 deficiency
  8. Neurosyphilis
  9. Hypothyroidism
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2
Q

WORK UP FOR:

  1. Vascular (“multiinfarct”) dementia
  2. Alzheimer disease
  3. Normal pressure hydrocephalus
  4. Chronic subdural hematoma
  5. Intracranial neoplasm
  6. Depression
  7. B12 deficiency
  8. Neurosyphilis
  9. Hypothyroidism
A
  1. CBC
  2. VDRL/RPR
  3. SerumB12
  4. TSH
  5. MRI-brain
  6. CT-head
  7. LP-CSF analysis
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3
Q

84 yo F brought by her son c/o forgetfulness (forgets phone numbers, loses her way back home) and difficulty performing some of her daily activities (bathing, dressing, managing money, using the phone). The problem has progressed gradually over the past few years.

A
  1. Alzheimer disease
  2. Vascular dementia
  3. Depression
  4. Hypothyroidism
  5. Chronic subdural hematoma
  6. Normal pressure hydrocephalus
  7. Intracranial neoplasm
  8. B12 deficiency
  9. Neurosyphilis
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4
Q

WORK UP FOR:

  1. Alzheimer disease
  2. Vascular dementia
  3. Depression
  4. Hypothyroidism
  5. Chronic subdural hematoma
  6. Normal pressure hydrocephalus
  7. Intracranial neoplasm
  8. B12 deficiency
  9. Neurosyphilis
A
  1. CBC
  2. VDRL/RPR
  3. SerumB12
  4. TSH
  5. MRI-brain
  6. CT-head
  7. LP-CSF analysis
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5
Q

72 yo M presents with memory loss, gait disturbance, and urinary incontinence for the past 6 months.

A
  1. Normal pressure hydrocephalus
  2. Alzheimer disease
  3. Vascular dementia
  4. Chronic subdural hematoma
  5. Intracranial neoplasm
  6. Depression
  7. B12 deficiency
  8. Neurosyphilis
  9. Hypothyroidism
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6
Q

WORK UP FOR:

  1. Normal pressure hydrocephalus
  2. Alzheimer disease
  3. Vascular dementia
  4. Chronic subdural hematoma
  5. Intracranial neoplasm
  6. Depression
  7. B12 deficiency
  8. Neurosyphilis
  9. Hypothyroidism
A
  1. CT-head
  2. MRI-brain
  3. LP-opening pressure & CSF analysis
  4. SerumB12
  5. VDRL/RPR
  6. TSH
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7
Q

55 yo M presents with a 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.

A
  1. Creutzfeldt·Jakob disease
  2. Vascular dementia
  3. Lewy body dementia
  4. Wernicke encephalopathy
  5. Normal pressure hydrocephalus
  6. Chronic subdural hematoma
  7. Intracranial neoplasm
  8. Depression
  9. Delirium
  10. B12 deficiency
  11. Neurosyphilis
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8
Q

WORK UP FOR:

  1. Creutzfeldt·Jakob disease
  2. Vascular dementia
  3. Lewy body dementia
  4. Wernicke encephalopathy
  5. Normal pressure hydrocephalus
  6. Chronic subdural hematoma
  7. Intracranial neoplasm
  8. Depression
  9. Delirium
  10. B12 deficiency
  11. Neurosyphilis
A
  1. CBC
  2. Electrolytes, calcium
  3. Serum B12
  4. VDRL/RPR
  5. MRI -brain (preferred)
  6. CT-head
  7. EEG
  8. LP-CSF analysis
  9. Brain biopsy
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9
Q

70 yo insulin·dependent diabetic M presents with episodes of confusion, dizziness, palpitations, diaphoresis, and weakness.

A
  1. Hypoglycemia
  2. Transient ischemic attack
  3. Arrhythmia
  4. Delirium
  5. Angina
  6. Medication·induced
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10
Q

WORK UP FOR:

  1. Hypoglycemia
  2. Transient ischemic attack
  3. Arrhythmia
  4. Delirium
  5. Angina
  6. Medication·induced
A
  1. Glucose
  2. CBC
  3. Electrolytes, TSH
  4. CPK·MB, troponin
  5. Echocardiography
  6. ECG
  7. MRI-brain
  8. Doppler U/S-carotid
  9. Urine toxicology
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11
Q

55 yo F presents with gradual altered mental status and headache. Two weeks ago she slipped, hit her head on the ground, and lost consciousness for 2 minutes.

A
  1. Subdural hematoma
  2. SIADH (causing hyponatremia)
  3. Creutzfeldt-Jakob disease
  4. Intracranial neoplasm
  5. CNS infection ( eg, encephalitis)
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12
Q

WORK UP FOR:

  1. Subdural hematoma
  2. SIADH (causing hyponatremia)
  3. Creutzfeldt-Jakob disease
  4. Intracranial neoplasm
  5. CNS infection ( eg, encephalitis)
A
  1. CT-head
  2. CBC
  3. Electrolytes, TSH
  4. MRI-brain
  5. LP-CSF analysis
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First Aid: Step 2 CS (23 decks)

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