Our latest Interactive Medical Case, ” A Startling Decline,” is now available.
An 89 year-old presented with changes in cognition and personality. Six months earlier, he began to require help managing his finances and operating his computer. His family observed that he had a poor memory for recent events and found it difficult to express himself.
What diagnostic and management steps do you choose? Receive feedback on your choices and learn more about his condition and optimal treatment steps at NEJM.org. You may also wish to browse previous Interactive Medical Cases and try more.
Investigations:
CBC with PS, CMP, Chest X Ray, UA with microscopy, CT Head Non Contrast
D/D:
Dementia,( Alzheimer’s)
Pick’s Disease
Subdural hematoma
Intra cerebral Hemorrhage
Mutiple infarction stroke
Hyponatremia
Assesment and Management
Determine home situation and caregivers.
Consider assisted living
Trial of Aricept