A 75-Year-Old Man Is Brought to the Office for Evaluation

question 243

Multiple Choice

A 75-year-old man is brought to the office for evaluation due to memory loss and increasing confusion for 6 months.  The patient is unable to manage his finances and occasionally gets lost in his neighborhood, needing to ask for directions.  On examination, he can recall only 1 of 3 objects after 5 minutes.  The patient performs poorly on cognitive assessment testing.  Cranial nerves and gait are normal.  T2-weighted MRI reveals multiple white matter abnormalities (hyperintensities) within the left frontal, bilateral parietal, and occipital white matter.  Also noted are subcortical gray matter hyperintensities in the bilateral thalamus.  Which of the following is the most likely diagnosis?

• A)Alzheimer dementia
• B)Brain metastases
• C)Multiple sclerosis
• D)Vascular dementia
• E)Wernicke encephalopathy

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Definitions:

Jaundice

Yellowish staining of the integument, the sclerae, and the other tissues with bile pigments.

Interferon Production

The process by which cells produce interferons, proteins that are part of the immune response to viruses.

Viral Infection

The invasion and multiplication of viruses within a host organism, leading to disease by damaging or killing cells or by triggering an immune response.

Circulatory Changes

Alterations in the flow of blood throughout the body, which can occur due to various health conditions or physiological states.