Friday, April 15, 2016

Step 2 CS: Memory loss / confusion

Soo.. I wanted to remember "medical terms" to report my findings in my patient note. I made a mnemonic for remembering "findings in Alzheimer's disease:

AC MI EF

- Decline in Activities of daily living
- Cognitive decline
- Memory Impairment
- Executive Functioning

For activities of daily living, DEATH SHAFT is a tedious mnemonic. Keep it simple -ABCD
Ask for ABCD - accounts, bathing, cooking, dressing and transport - Can you walk in the house / drive a car?

Other diagnoses:

Normal Pressure Hydrocephalus - Ask for urinary incontinence, gait disturbance

Syphilis / AIDS - Have you ever been diagnosed with a STD in the past?

Major depressive disorder (Psuedodementia) - SIGECAPS

Hypothyroidism - Cold intolerance, constipation, slowing of movement, etc

B12 deficiency - Gait disturbance, tingling numbness, diet

Vascular dementia - Ask for stroke, HTN

When acute onset of confusion:

Drug induced delirium - Ask for new medications

Post operative delirium - Ask for recent surgery

Delirium due to infection / electrolyte imbalance - Pneumonia, UTI

Diagnostic studies:
CT brain, MRI head
RPR, TSH, B12, CBC
Do electrolytes to rule out - Hyperkalemia, Hypercalcemia, Hyperglycemia, uremia

Physical examination - Do MMSE, gait

Related post: Writing psychiatry note and MMSE

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