An 81-Year-Old Woman Is Brought to the Office for Assessment

question 366

Multiple Choice

An 81-year-old woman is brought to the office for assessment of behavioral changes over the past 10 months.  The patient moved to a nursing home a year ago, and initially enjoyed playing simple card games there with other residents.  Now she either seems uninterested in playing or quickly becomes upset during games, repeating, "I can't, I can't, I can't."  She also becomes easily irritable and pushes staff away when they try to help her dress or comb her hair.  The patient has had increasing difficulty recalling recent events and has started accusing staff of stealing her jewelry.  Sleep and appetite are unchanged.  The patient has a history of hypertension and noninsulin-dependent diabetes mellitus, as well as postpartum depression in her 20s.  Temperature is 37 C (98.6 F) , blood pressure is 140/90 mm Hg, and pulse is 86/min.  Physical examination is unremarkable.  She is oriented to person and place but not to time or day.  Short-term recall is very poor.  Her mood is "OK."  Laboratory results, including electrolytes, complete blood count, thyroid function tests, and vitamin B₁₂, are normal.  Rapid plasma reagin is negative; fluorescent treponemal antibody absorption test is nonreactive.  MRI of the brain reveals mild generalized cortical atrophy and slightly reduced hippocampal volume.  Which of the following is the most appropriate statement regarding this patient's prognosis?

• A)The patient's current behavioral changes require initiation of antipsychotic medication.
• B)The patient's condition is irreversible and will continue to worsen.
• C)The patient's memory problems and behavior will likely improve with antidepressant treatment.
• D)The patient will have a stepwise decline in her mental status and functioning over time.
• E)The patient will improve once the underlying medical cause of her mental status changes has been identified and treated.

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Definitions:

Partnership Agreement

A contract between partners in a business outlining the terms, responsibilities, and profit distribution of the partnership.

RUPA

The Revised Uniform Partnership Act, which provides a legal framework for the formation, operation, and termination of partnerships in the United States.

Wrongful Dissociations

Refers to instances where a member of a partnership or an entity leaves the partnership in violation of the agreement or under circumstances that are damaging to the partnership's or the entity's operations.

Wrongful Dissociation

A term referring to the improper withdrawal of a partner from a partnership or a member from a limited liability company (LLC), which can lead to potential legal and financial penalties.