#february2020mccqe1
An 81-year-old woman is evaluated in the office for increasing difficulty with activities of daily living, including dressing and feeding herself, over the past 6 months. She has had gradually progressive cognitive decline for the past 5 years and now needs 24-hour help from a caregiver; Alzheimer dementia was previously diagnosed. Current medications are donepezil and a daily multivitamin. On physical examination, vital signs are normal. Her level of alertness, speech, and gait are normal. The patient scores only 12/30 on the Folstein Mini-Mental State Examination. Results of a complete blood count, a basic metabolic panel, a serum vitamin B12 measurement, and thyroid function tests are normal. A CT scan of the head without contrast shows no evidence of tumor, hemorrhage, or infarction.
Which of the following is the most appropriate next step in treatment?
(A) Add memantine
(B) Add quetiapine
(C) Add sertraline
(D) Stop donepezil
An 81-year-old woman is evaluated in the office for increasing difficulty with activities of daily living, including dressing and feeding herself, over the past 6 months. She has had gradually progressive cognitive decline for the past 5 years and now needs 24-hour help from a caregiver; Alzheimer dementia was previously diagnosed. Current medications are donepezil and a daily multivitamin. On physical examination, vital signs are normal. Her level of alertness, speech, and gait are normal. The patient scores only 12/30 on the Folstein Mini-Mental State Examination. Results of a complete blood count, a basic metabolic panel, a serum vitamin B12 measurement, and thyroid function tests are normal. A CT scan of the head without contrast shows no evidence of tumor, hemorrhage, or infarction.
Which of the following is the most appropriate next step in treatment?
(A) Add memantine
(B) Add quetiapine
(C) Add sertraline
(D) Stop donepezil
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