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Abuse grief etc 10 20 are due to treatable causes

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, abuse, grief, etc.]*10-20% are due to treatable causes such as B12 deficiency, infection, polypharmacy,alcohol or drug abuse.*Is this their normal or baseline mental status?*Psychosocial factors: depression, anxiety and grief as well as possible elder abuse6
UA: to evaluate infection, proteinuria, hematuria, glucosuriaCBC: leukocytosis; anemiaBMP: look at renal function, hyponatremia, hypokalemia [STM loss is associated withb12 deficiency]RPR: tertiary syphilis [still a strong possibility in patients of any age but particular theelderly]ESR: look for inflammation[may be elevated in the elderly secondary to otherprocesses]TSH: rule out metabolic encephalopathyCXR: rule out pneumonia / COVID in patient w/cough, congestion, feverEKG: cardiac abnormalities that need further work upEEG: consider w/suspicion for seizure activity or encephalopathyCarotid US: better option to evaluate for possible stenosis that would be the source7
of TIAs and transient confusionCT scan: GOLD STANDARD for dementia work up; often useful for ruling out stroke,massesMRI: may show additional details. Consider that the CT may be required prior to anMRI; insurances may require a precertification for a CT or MRIToxicology screen: order based upon hx and risk [ETOH and drug screens.24-hr Urine Collection: heavy metals screenLP: if CNS infection is suspected [systemic signs]7
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TREAT REVERSIBLE CAUSES: Nutritional deficiency, anemia, hypoxia, acute obstructivehydrocephalus, and even environmental changes such as exposure, trauma, stress,psychosis9
Pick's disease:rare neurodegenerative disease that causes progressive destruction ofnerve cells in the brainSymptoms:loss of speech (aphasia) and dementia [while some symptoms can initiallybe alleviated, the disease PROGRESSIVE! Patientsoften die within two to ten yearsDefining Characteristic:build-up of tau proteins in neurons, accumulating into silver-staining, spherical aggregations known as "Pickbodies”While the term Pick's disease was once used to represent a class of clinicalsyndromes with symptoms attributable to frontal and temporal lobe dysfunction, it isnowused among professionals to mean a specific pathology that is one of thecauses of frontotemporal lobar degenerationSome people use the term Pick's disease to mean the more general clinical syndromeof frontotemporal lobar degeneration, but this has previously led to confusion amongprofessionals and patients:the FIRST noticeable difference between Pick Diseaseand Alzheimer’s is the PERSONALITY change that hallmarks the onset of Pick’sdisease versus the short term memory loss of Alzheimer’s.Lewy body dementia:SECOND most common type of progressive dementia afterAlzheimer's disease10
Etiology:progressive decline in mental abilitiesPatho:protein deposits “Lewy bodies” develop in nerve cells in regions of the braininvolved in thinking, memory and movement motor control]Visual hallucinations[generally take the form of objects, people or animals thataren't thereà

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Term
Fall
Professor
NoProfessor
Tags
The American, Seizure, Seizure types

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