sweetybokhari
Forum Elite
Topics: 118
Posts: 148
|
A man 65 year labile mood,depression forgetful for 2 years,he has long standing hypertension,o/e cognitive junctions partial impairment,absent ankle jerk.dx?
a) alzheimer
2) pseudodementia
C) multinfarct dementia
|
| Dr.Luck
Forum Senior
Topics: 12
Posts: 225
|
pseudodementia due to his depression as in alzeihmer's dz there's more cognitive disfunction & course of dz is longer & in multi infarct there would be findings of neurologic deficit.
|
| ts97
Forum Senior
Topics: 13
Posts: 128
|
Dementia + hypertension + neurologic signs = multinfarct dementia
|
| coolmavs
Forum Elite
Topics: 21
Posts: 327
|
HTN --> In this case indicates, Multi-infarct dementia.
___________________
Yeh Zeher bhi, yoon piya hai.....Jaise sharaab ho!!!!
|
| kelash kumar
Forum Newbie
Topics: 0
Posts: 5
|
h/o HTN, focal neurologic signs indicate multi infarct dementia
|
| neo335
Forum Elite
Topics: 39
Posts: 174
|
i am not sure if any focal neuroligical signs have been mentioned. also, HTN is a risk factor for micro infarcts and that could lead to multiinfarct dementia. however, there has been no mention of any episode on infarctions or any similar signs. nor is there a mention of step wise proggression of the dementia. as for the reflexes.. the age makes it likely for a natural decrease of the ankle jerk. so even though HTN is a risk factor, its not the cause here
on the other hand, depression is the cause for the psuedo dementia. n the pt has depression. also the pt can statethe onset of the memory problem. alzheimers go on for years b4 they realise their problem.. so the pt shud b put on TCAs n u'd see an improvement of memory along with the mood.
i wud appreciate ur inputs and correction in my explaination incase its wrong.. thank u n all the best!!!
|
| NE
Forum Guru
Topics: 53
Posts: 504
|
In multi infarct dementia the cognitive impairment is step wise - one infarct ----more impairment! It is not such a description here and decrease ankle jerk is not a neurologic sign- could be normal in elederly!
It is hard to do differential dx between pseudodementia and Alzheimer here but I guess Alzheimer is the right answer; he has gradual onset and family became aware of his symptoms after 2 years.
Anyway, very foggy question....
|
|
| |
| | | | | | | |
