elitoki
Forum Guru
Topics: 54
Posts: 508
|
An 82 y/o w is brought to the physician by her granddaughter because of a 6 wk history of increasing forgetfulness. she is a retired schoolteacher and lives independently. her grandaughter is concerned because on several occasions she has left the stove on when se went to bed. During conversations with her granddaughter, she has difficulty remembering past events and seems unconcerned about her memory lapses. The patient describes trouble sleeping through the night and has had a decreased appetite resulting in a 4.5 kg weight loss over the past month. she has a history of similar symptoms 2 and 5 yrs ago that were successfully treated with medication. she appears unkempt and has poor personal hygiene. her temperature is 37, BP is 110/70, pulse 80 and regular. MSE shows psychomotor retardation, a flat affect, impaired ability to recall past events, and trouble repeating three numbers in sequence. she is unable to recall the names of recent presidents. her BUN is 25, creatinine is 1.7
1.acute stress disorder
2.dementia, alsheimer type
3.dissociative amnesia
4.general paresis
5.head trauma
6.hepatolenticular degeneration ( wilson's disease)
7.HIV encephalitis
8.Huntington's disease
9.Major depressive disorder
10.Multi-infarct dementia
11.Niacin deficiency
12.normal pressure hydrocephalus
13.parkinson's disease
14.pick's disease
15.schizophrenia, catatonic type
16. normal aging.
|
| kpmle2
Forum Elite
Topics: 29
Posts: 290
|
9.Major depressive disorder
|
| dermatology
Forum Elite
Topics: 30
Posts: 293
|
wud go for 2. Alziehmers
|
| Justice
Forum Fanatic
Topics: 100
Posts: 1,901
|
Choosing b/w 2 and 9... I doubt any treatment for 2 would successfully help 2 and 5 years ago... So, have to go with 9.Major depressive disorder
___________________
Don't live in a town where there are no doctors
|
| Dr.D
Forum Senior
Topics: 22
Posts: 191
|
9
|
| tamerbashir
Forum Elite
Topics: 20
Posts: 284
|
9
|
| Ivonne
Forum Guru
Topics: 53
Posts: 1,403
|
The answer given is 2 alzheimer can someone explain how a progressive disease could be successfully treated 2 years ago as indicated by q stem?
___________________
If you beleive you can do it then you WILL DO IT!! (by Mymeghhi)
|
| drshvetasm
Forum Elite
Topics: 22
Posts: 278
|
yes Ivonne the answer is 2. Dementia,Alzheimers type and not depression coz depressed ppl r concerned bout their memory loss and its clearly mentioned in this that she is unconcerned bout her memory loss. the affect too is flat...no depressive symptoms.
|
| drshvetasm
Forum Elite
Topics: 22
Posts: 278
|
Alzheimers ppl generally complain of exactly this...leaving the stove on and forgetting bout it, or forgetting if they have taken their meds already. mebbe the previous episodes were depressive..the ones 2 and 5 yrs ago...they seemed similar coz they were pseudodementia...but this one surely is alzheimers....iN my opinion
|
| AAAAA
Forum Fanatic
Topics: 153
Posts: 1,983
|
Alzehemier Dementia
___________________
seeking study partner in USMLE examination
|
| smalley
Forum Elite
Topics: 51
Posts: 284
|
why cant it be 10 multi infarct dementia? step wise deterioration,previously successfully treated?
some1 pls expain?
___________________
But they that wait upon the LORD shall renew their strength; they shall mount up with wings as eagles; they shall run, and not be weary; and they shall walk, and not faint-Isaiah 40:31
|
| Vietnamese
Forum Elite
Topics: 11
Posts: 278
|
10- Multi-infarct dementia.
I think some sucessful treatment may be the secondary stroke prevention as high-dose aspirine or warffarin in the previous periods.
Major depression must be met some criteria: at least 1 major symptom (depressed mood) + some minor ones; flat effect is not depressed mood.
___________________
Nothing is impossible.
|
|
| |
| | | | | | | | | | | | |
