CONFUSION/MEMORY LOSS

Question 1

Vascular dementia DDx:

8

Answer 1

1. AD.
2. NPH.
3. Chronic subdural hematoma.
4. Intracranial neo.
5. Depression.
6. B12.
7. Syph.
8. Hypothyroidism.

Question 2

Vascular dementia workup:

7

Answer 2

1. CBC.
2. VDRL/RPR.
3. B12.
4. TSH.
5. MRI-brain.
6. CT-head.
7. LP-CSF analysis.

Question 3

AD DDx:

8

Answer 3

1. Vascular dementia.
2. Depression.
3. Hypothyroidism.
4. Chronic subdural hematoma.
5. NPH.
6. Intracranial neo.
7. B12.
8. Syph.

Question 4

AD workup:

7

Answer 4

1. CBC.
2. VDRL/RPR.
3. B12.
4. TSH.
5. MRI—brain.
6. CT-head.
7. LP-CSF analysis.

Question 5

NPH DDx:

8

Answer 5

1. AD.
2. Vascular.
3. Chronic subdural hematoma.
4. Intracranial neo.
5. Depression.
6. B12.
7. Syph.
8. Hypothyroidism.

Question 6

NPH workup:

6

Answer 6

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

Question 7

CJD DDx:

10

Answer 7

1. VD.
2. LBD.
3. Wernicke encephalopathy.
4. NPH.
5. Chronic subdural hematoma.
6. Intracranial neo.
7. Depression.
8. Delirium.
9. B12.
10. Syph.

Question 8

CJD workup:

9

Answer 8

1. CBC.
2. Electrolytes — calcium.
3. B12.
4. VDRL/RPR.
5. MRI—brain.
6. CT-head.
7. EEG.
8. LP—CSF analysis.
9. Brain biopsy.

Question 9

Hypoglycemia DDx:

4

Answer 9

1. TIA.
2. Arrhythmia.
3. Delirium.
4. Angina.

Question 10

Hypoglycemia workup:

8

Answer 10

1. Glucose.
2. CBC.
3. Electrolytes.
4. CPK-MB, troponin.
5. Echocardiography.
6. ECG.
7. MRI—brain.
8. Doppler US—carotid.

Question 11

Subdural hematoma DDx:

3

Answer 11

1. SIADH (causing hyponatremia).
2. CJD.
3. Intracranial neo.

Question 12

Subdural hematoma workup:

5

Answer 12

1. CT—head.
2. CBC.
3. Electrolytes.
4. MRI-brain.
5. LP—CSF analysis.

Question 13

Key Physical Exam Steps for Confusion/Memory Loss

Answer 13

Vitals
Complete Neuro Exam w/ MMSE and Gait
ENT, CV, Pulm, Abdomen, Extremities

Question 14

Key History for Confusion/Memory Loss

Answer 14

History from family members/caregivers
Chronicity of cognitive deficits
Associated Sx (constitutional, incontinence, ataxia, hypothyroidism, depression)
Screen for delirium (waxing/waning alertness)
Falls
Meds and Med changes
H/o CVA, syphilis, HIV, EtOH, B12 deficiency
Fam Hx of Alzheimers or other neuro disease