NBME loves to ask about complaints in elderly patients to assess whether you know which changes are physiological vs. pathological (same with newborns and developmental milestones)
In this patient, all of the findings are normal except for the memory loss because it has only been present for 1 month, which does not correspond with the typical picture of Alzheimerโs
Patients with suspected cognitive impairment are often worked up with cognitive tests (MOCA, MMSE, Mini-Cog), Lab testing (CBC, B12, TSH, BMP +/- syphilis) and Imaging (CT or MRI of brain)
-Key idea: Mild cognitive impairment = short-term memory/cognitive problems that are concerning to patient/family but that DONโT affect daily life or ADLs (using phone, driving, cooking, etc.)
tinylilronI am confused as well. Is it because of the rapid nature of memory loss?+1
shastri96Presbycusis
presbyopia
diminished ankle reflex
Old age related tremor
all are common old age conditions so they dont require urgent evaluation.+10
nayyyyAlso that she felt well and was not concerned about it? Maybe.. lol+2
lubdubAnd the memory loss is leading to danger- leaving the stove on. Gotta get that in check. +2
lindasmith462the most specific sx for dementia is impaired functioning in ADLs - getting lost in familiar surroundings is a SUPER common one. (lol I've def accidently left the stove on during step studying - stupid electric stoves) +1
whoopthereitisI remember a UWorld question describing how loss of DTR at the ankles, aka Achilles reflex bilaterally, is a normal finding with aging--guessing the same logic for most of the rest +
submitted by โabhishek021196(120)
Quoting step-prep - https://step-prep.org/tutoring/
Memory loss
NBME loves to ask about complaints in elderly patients to assess whether you know which changes are physiological vs. pathological (same with newborns and developmental milestones)
In this patient, all of the findings are normal except for the memory loss because it has only been present for 1 month, which does not correspond with the typical picture of Alzheimerโs
Patients with suspected cognitive impairment are often worked up with cognitive tests (MOCA, MMSE, Mini-Cog), Lab testing (CBC, B12, TSH, BMP +/- syphilis) and Imaging (CT or MRI of brain)
-Key idea: Mild cognitive impairment = short-term memory/cognitive problems that are concerning to patient/family but that DONโT affect daily life or ADLs (using phone, driving, cooking, etc.)