A 65-year-old woman presents to her primary care physician with complaints of new-onset memory loss. Her family reports that she has been forgetting recent events, repeating questions, and misplacing items more frequently over the past few months. She has no significant medical history but has noticed a decline in her cognitive abilities. On examination, she demonstrates difficulty recalling recent events and exhibits word-finding difficulties. Her Mini-Mental State Examination (MMSE) score is 20/30. What is the most likely diagnosis for this patient, and what are the hallmark clinical manifestations? (Select all that apply)
Loss of short-term memory
Alzheimer’s disease
Vascular dementia
Word-finding difficulties
Correct Answer : A,B,D,E
Choice A reason: Loss of short-term memory is a hallmark of Alzheimer’s disease, as seen in the patient’s difficulty recalling recent events. This reflects early hippocampal damage, impairing new memory formation, making it a correct clinical manifestation for this diagnosis.
Choice B reason: Alzheimer’s disease is the most likely diagnosis, given progressive memory loss, word-finding difficulties, and an MMSE score of 20/30 in a 65-year-old. These symptoms align with Alzheimer’s neurodegenerative pattern, making this the correct diagnosis.
Choice C reason: Vascular dementia typically presents with stepwise cognitive decline and focal neurological signs, often with vascular risk factors. The patient’s gradual memory loss without such history better fits Alzheimer’s, making vascular dementia incorrect.
Choice D reason: Word-finding difficulties, as exhibited, are a hallmark of Alzheimer’s, reflecting language cortex involvement. This progressive aphasia, common in early stages, impairs communication, making it a correct clinical manifestation for this patient.
Choice E reason: Disorientation to time and place, though not explicitly stated, is a hallmark of Alzheimer’s, often emerging as memory declines. Given the patient’s MMSE score and symptoms, this is likely, making it a correct manifestation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: T cells, including cytotoxic and helper T cells, drive cell-mediated immunity by directly attacking infected cells and coordinating immune responses. They target intracellular pathogens and tumors, forming the core of cellular immunity, making this the correct choice.
Choice B reason: B cells mediate humoral immunity, producing antibodies against extracellular pathogens. While critical for immune defense, they do not directly drive cell-mediated responses, which rely on T-cell activity, making this incorrect for cell-mediated immunity.
Choice C reason: “None of the above” is incorrect, as T cells play a central role in cell-mediated immunity. Their functions, like cytotoxicity and cytokine production, are essential for this immune response, making this an invalid choice.
Choice D reason: “All of the above” is incorrect, as only T cells, not B cells, are primarily responsible for cell-mediated immunity. B cells support humoral immunity, not the cellular response driven by T cells, making this an incorrect choice.
Correct Answer is B
Explanation
Choice A reason: Inward-pointing feet, or pigeon-toed appearance, describe intoeing, often due to metatarsus adductus or tibial torsion. Genu varum involves the knees angling outward, causing a bowed leg appearance, not foot positioning, making this an incorrect description.
Choice B reason: Genu varum, or bowlegs, is characterized by knees angling outward, creating a bowed appearance of the legs. This condition, common in toddlers or due to conditions like rickets, matches the described deformity, making this the correct description.
Choice C reason: Knees angling inward, causing a knock-kneed appearance, describes genu valgum, not genu varum. These are opposite deformities, with genu varum involving outward knee angulation, making this an incorrect description of the condition.
Choice D reason: Hyperextension of the knee joint, causing excessive leg straightening, describes genu recurvatum, not genu varum. Genu varum involves lateral knee angulation, not hyperextension, making this an incorrect description of the condition.
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