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A Patient with Memory Loss
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Certified
for 1 AMA PRA Category 1 Credit™
Co-Sponsored
by
the
University
of Alabama
School
of
Medicine
Division of Continuing Medical Education,
Division of Gerontology, Geriatrics, and
Palliative Care, and
The Center for Aging
| Release
Date: June 1, 2007 |
Expiration
Date: June 1, 2010
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| TARGET
AUDIENCE: |
| Primary
care physicians |
| OBJECTIVES: |
| Upon
completion of this CME activity,
physicians and other healthcare professionals
should be able to: |
- list the diagnostic criteria for dementia.
- distinguish between different types of dementias.
- list the diagnostic criteria for depression.
- describe what medications are preferred in dementia for treatment of depression.
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| Top of Page |
| SOURCE: |
| EDITOR
AND CONTRIBUTING AUTHOR: |
|
Angela
R. Curtis, PhD
Managing Editor
Assistant Professor, Geriatric Education
Manager
Sara Rahman, MD
Assistant Professor
Division
of Gerontology, Geriatrics and
Palliative Care
University of Alabama at Birmingham
Birmingham, Alabama
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| Top of Page |
| |
| DISCLOSURE: |
The
faculty has no commercial affiliations
to disclose.
Because of the nature of preliminary
studies, some products mentioned are
unlabeled and investigational. Dosages,
indications, and methods of use of
drugs mentioned in this publication
may reflect the experience of the authors,
clinical literature, or other resources.
Therefore, please see the full prescribing
information before using any licensed
product mentioned. |
| CME
PARTICIPATION: |
| To
participate in this online course
for CME credit, please review the
objectives before beginning the program.
Complete the course and the self-assessment
test before June 1, 2010 to receive
CME credit. Your certificate will
then be available online. This process
should take approximately 1 hour. |
| ACCREDITATION: |
|
The
University of Alabama School of
Medicine is accredited by the Accreditation
Council for Continuing Medical
Education to provide continuing
medical education for physicians.
The
University of Alabama School of
Medicine designates this educational
activity for a maximum of 1 AMA
PRA Category 1 Credit™.
Physicians should only claim credit
commensurate with the extent of
their participation in the activity.
The
boards of nursing in many states,
including Alabama, recognize Category
1 continuing medical education
courses as acceptable activities
for the renewal of license to practice
nursing.
|
| DISCLAIMER: |
| Dosages,
indications, and methods of use of
any drug referred to in this publication
may reflect the clinical experience
of the authors, clinical literature,
or other clinical resources. Therefore,
please see the full prescribing information
before using any product mentioned.
UAB is an equal opportunity/affirmative
action institution. |
| CASE: |
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A 71-year-old white male presents as a new patient for evaluation of memory loss. He states that his short term memory has been poor for the last three months. His wife, who accompanies him to the visit, states that his memory has been slowly declining over the last three years. Over the last three months the decline has been more pronounced since they moved from the northeast to Alabama to be closer to family. He is now unable to balance his checkbook. While driving one week ago, he became lost returning from the store. He called his son to come and get him because he was unable to find his way. A few weeks ago, he left a pot on the stove that proceeded to burn and set off the fire alarm. Over the last few months, he has intermittently forgotten to shower himself and requires verbal prompting from his wife to remind him. He denies any falls or any numbness, tingling, or weakness in his extremities.
His past medical history is significant for:
- benign prostatic hypertrophy for twelve years
- depression six years ago, when he retired, that self-resolved and was not treated with medication
- hypertension for 10 years.
He currently takes flomax 0.4 mg daily and lisinopril 20 mg daily. He worked as an accountant for many years and retired at age 65. He has two sons that live in the area. He smoked cigarettes when he was young but has not smoked in 40 years. He has one glass of wine at night. Family history includes hypertension, coronary artery disease, depression, and stroke. His review of symptoms is positive only for nocturia, which has been longstanding. His wife states that, at times he becomes short tempered when he has forgotten something or is unable to do a task correctly. He admits to frustration with his lack of short term memory. He denies any current depression or anxiety. He has not shown any physically aggressive behavior, hallucinations, or inappropriate behavior.
Physical Exam: He is a well-groomed elderly male in no acute distress. His vital signs are normal. Gait is normal. Physical Exam is normal.
Mini Mental Status Exam:
He is unable to recall the day of the week, date, month, season, or year. = 0/5
He was able to recall his city, state, and location in a medical clinic but not his current address or the county. = 3/5
He was able to repeat 3 objects immediately after interviewer. = 3/3
He was unable to spell world backwards (he spelled it dow). = 3/5
He was unable to recall three objects at five minutes. = 0/3
He was able to name a pencil and a watch. = 2/2
He repeated “no ifs, ands, or buts” correctly. = 1/1
He followed a 3 step command. = 3/3
He read “close you eyes” and obeyed. = 1/1
He wrote a complete sentence. = 1/1
He successfully copied interlocking pentagons. = 1/1
He scored 18/30.
The patient became frustrated and embarrassed when unable to answer all questions appropriately. Otherwise, he had a normal affect.
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