4-day history of increasing confusion and memory problems

Discussion in 'USMLE STEP 2 CS' started by rex, Jun 28, 2008.

  1. rex

    rex Guest

    A 72-year-old man is brought to the physician by his son because of a 4-day history of increasing confusion and memory problems. The son says that his father's ability to function independently has been generally declining over the past few years, and he has become much more impaired over the past week. The patient has had at least three to four
    previous episodes of a sudden decline of cognitive functioning over the
    past 3 years without full recovery. He has a history of hypertension.
    His blood pressure is 160/95 mm Hg without orthostatic changes. Neurologic examination shows no focal findings. Mini-Mental State Examination score is 21/30. Which of the following is the most likely underlying pathophysiologic process?

    A) Central nervous system demyelination

    B) Central nervous system infection

    C) Diffuse axonal injury

    D) Diffuse cortical atrophy

    E) Left temporal lobe infarction

    F) Multiple, small, central nervous system infarctions

    G) Subdural hematoma
  2. Etai

    Etai Guest


    Emedicine says:
    "Commonly, progressive cognitive deficits and dementia can result from multiple temporally staggered small cerebral infarcts."

    This is the second most common cause of dementia, after Alzheimer's.
  3. Etai

    Etai Guest

    This is also supported by the high BP.
  4. Guest

    Guest Guest

    there is no focal so It is Alzh

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