Topic: Alzheimer's Disease
Subject: Medicine
Which one of the following tests is most useful for the initial workup of suspected Alzheimers disease?
Carotid Doppler ultrasonography
An erythrocyte sedimentation rate
A cardiac stress test
A TSH level
Correct Answer :
D. A TSH level
Occult hyper- or hypothyroidism can imitate the symptoms of Alzheimers disease, especially in the elderly, and thus should be considered in the initial workup.
>Cardiac stress testing, carotid Doppler ultrasonography, and an erythrocyte sedimentation rate are not part of the routine evaluation for Alzheimer's dementia.
>A lumbar puncture for cerebrospinal fluid pressures would be indicated only if normal pressure hydrocephalus is suspected.
>Neither the cerebral angiogram nor the cardiac stress test is useful for the initial evaluation of Alzheimer's disease.
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A 53-year-old male accountant comes to your office with progressive facial weakness on the left side that began yesterday. He also reports pain behind the left ear and decreased lacrimation from the left eye. He has been in good health and had his yearly physical examination 1 week ago, which was normal. His lipid levels, chemistry profile, and CBC were all normal. He has not been involved in any outdoor activities, nor does he engage in any high-risk sexual behavior. On examination, there is flattening of the left nasolabial fold and decreased ability to close the left eye. The mouth appears to be drawn to the right. The remainder of his general examination and neurologic examination are normal.
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Subject: Medicine
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Subject: Medicine
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