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Self-Assessment Questions

Family Medicine

Memory Loss: Review Questions

Barbara Fogle Mercer, MD

Dr. Mercer is an associate professor of Family Medicine, Michigan State University, Flint, MI.


Choose the single best answer for each question.

1. A 74-year-old woman presents to your office complaining of difficulties with her memory. In your evaluation, all of the following should be considered EXCEPT:
  1. A relative or other close observer
    should corroborate her history
  2. In healthy older persons, the ability
    to learn new information declines
  3. The history should include
    medication use
  4. Her chance of having Alzheimer’s dementia is less than 5%
  5. Knowledge of the patient’s social functioning is important in the
    diagnosis of dementia
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2. All of the following are known reversible causes of dementia EXCEPT:

  1. Hypercalcemia
  2. Major depression
  3. Normal-pressure hydrocephalus
  4. Parkinson’s disease
  5. Vitamin B12 deficiency
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3. Which of the following statements regarding the Folstein Mini-Mental State Examination (MMSE) is correct?

  1. A person who scores 21 points
    or fewer has dementia
  2. Abstract thinking is one of the components of the MMSE
  3. The MMSE can differentiate between vascular dementia and Alzheimer’s dementia
  4. Educational background does not have to be considered when scoring the MMSE
  5. The MMSE has both written and verbal responses
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  4. An 80-year-old man is admitted to the hospital for pneumonia. He has a history of hypertension and mild dementia. After admission, he becomes agitated, anxious, and more confused than his baseline. He is disoriented but cooperates with medical treatment. His family is present. Which of the following is most appropriate for the management of this patient with delirium?
  1. Observation
  2. Restrict family visits
  3. Use physical restraints to prevent
    the patient from pulling out his
    intravenous line
  4. Administer haloperidol 0.5 mg
    twice per day
  5. Administer lorazepam 1 mg
    intravenously every 6 hours
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5. A 69-year-old woman has recently been diagnosed with Alzheimer╣s disease by a local neurologist. She returns to her family physician for follow-up management. All of the following are reasonable initial management strategies EXCEPT:

  1. Begin a cholinesterase inhibitor
    such as donepezil
  2. Start donepezil and vitamin E
  3. Start sertraline only
  4. Provide counseling and refer
    the family to the Alzheimer’s
    Association for education and
    support groups
  5. Obtain clarification of the patient’s treatment wishes prior
    to her incapacitation
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