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A 74 year old white female retired grade school teacher was brought in
to you office by her daughter. The patient after being found wandering around
her neighborhood in her bathrobe. The neighbor who found her said she was "incoherent".
Upon questioning the family they state that they first noticed a
problem with the patient's memory about 3 y ago, but they attributed it to her
being depressed after her husband of 45 y died. The patient then moved
in with her daughter because the family worried that the patient wasn't
eating, was forgetting to pay her bills and was mismanaging her checkbook.
They also noted she was misplacing things, forgetting her grandchildrens'
names and she had to stop driving because she kept getting lost (even though
she used to drive back and forth to her daughter's house weekly). Lately the pt
just sits in front of the T.V. and is refusing to bathe.
Questions:
- What are at least five possible causes of this patient's problem?
- What is the differential diagnosis and what are the distinguishing
features of each disease entity?
- What tests would you order to evaluate this patient?
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