Minicase - Confusion/Memory Loss Flashcards Preview

USMLE Step 2 CS > Minicase - Confusion/Memory Loss > Flashcards

Flashcards in Minicase - Confusion/Memory Loss Deck (14)
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1

W/u for vascular dementia (7)

1. CBC
2. VDRL/RPR (neurosyphilis)
3. Serum B12 (B12 deficiency)
4. TSH (hypothyroidism)
5. MRI brain (vascular dementia, neoplasm)
6. CT head (subdural hematoma, vascular dementia, NPH)
7. LP w/ CSF analysis

2

W/u for Alzheimer disease (7)

1. CBC
2. VDRL/RPR (neurosyphilis)
3. Serum B12 (B12 deficiency)
4. TSH (hypothyroidism)
5. MRI brain (vascular dementia, neoplasm)
6. CT head (subdural hematoma, vascular dementia, NPH)
7. LP w/ CSF analysis

3

W/u for NPH (6)

1. CT head
2. MRI brain
3. LP w/ CSF analysis and opening pressure
4. Serum B12
5. VDRL/RPR
6. TSH

4

W/u for CJD (9)

1. CBC
2. Lytes, calcium
3. Serum B12
4. VDRL/RPR
5. MRI brain (neoplasm)
6. CT head (NPH, subdural hematoma)
7. EEG (CJD)
8. LP w/ CSF analysis
9. Brain biopsy

5

W/u for hypoglycemia (11)

1. glucose
2. CBC
3. lytes
4. TSH
5. CPK-MB, troponin
6. ECHO (angina, arrhythmia)
7. EKG (angina, arrhythmia)
9. MRI brain
10. doppler U/S carotid (TIA)
11. Utox (medication-induced)

6

W/u for subdural hematoma (6)

1. CT head
2. CBC
3. lytes
4. TSH
5. MRI brain (neoplasm)
6. LP w/ CSF analysis (CNS infection)

7

Hx of multi-infarct dementia (4)

1. confusion/memory loss
2. timeline: long-term decline over years
3. PMHx: DM, HTN, strokes
4. stepwise decline in cognitive function
5. elderly

8

Hx of Alzheimer disease (5)

1. confusion/memory loss
2. elderly
3. gradual progression over years
4. forgetfulness
5. difficulty with ADLs

9

Hx of NPH (5)

1. confusion/memory loss
2. elderly
3. gait disturbane
4. urinary incontinence
5. timeline shorter (~ 6mo)

10

Hx of CJD (6)

1. confusion/memory loss
2. rapidly-progressive change (~2mo)
3. inability to concentrate
4. myoclonus
5. ataxia
6. startle response

11

Hx of hypoglycemia

1. confusion/memory loss
2. PMHx DM (w/ insulin)
3. episodic
4. confusion
5. dizziness
6. palpitations
7. diaphoresis
8. weakness

12

Hx of subdural hematoma

1. confusion/memory loss
2. gradual AMS
3. HA
4. hx of head trauma (~2wks)

13

Exams to consider (5)

1. vital signs (which should be given)
2. full neuro exam
3. MMSE
4. gait
5. general physical (heart, lungs, abd, extremities)

14

Main ddx of confusion/memory loss (6)

1. vascular dementia
2. Alzheimer disease
3. NPH
4. Creutzfeldt-Jakob disease
5. hypoglycemia
6. chronic subdural hematoma