#april2020mccqe1
An 83-year-old woman presents with a 1-year history of increasing forgetfulness and inattentiveness. She has had episodes of confusion, usually occurring at night when she wanders around in her house, disoriented to time and place. According to a family member, she has recently developed paranoid ideation. On a Mini-Mental Status examination, she is unable to recall one of three words, but she is able to follow a three-stage command. There is no history of alcohol abuse, major physical illness, or current pharmacologic therapy. Physical examination is unrevealing, and blood and thyroid function tests are within normal limits. Which of the following is the most appropriate next step in diagnosis?
(A) Electroencephalographic studies
(B) MRI of the brain
(C) Cerebral angiographic studies
(D) Lumbar puncture for CSF examination
(E) Brain biopsy
An 83-year-old woman presents with a 1-year history of increasing forgetfulness and inattentiveness. She has had episodes of confusion, usually occurring at night when she wanders around in her house, disoriented to time and place. According to a family member, she has recently developed paranoid ideation. On a Mini-Mental Status examination, she is unable to recall one of three words, but she is able to follow a three-stage command. There is no history of alcohol abuse, major physical illness, or current pharmacologic therapy. Physical examination is unrevealing, and blood and thyroid function tests are within normal limits. Which of the following is the most appropriate next step in diagnosis?
(A) Electroencephalographic studies
(B) MRI of the brain
(C) Cerebral angiographic studies
(D) Lumbar puncture for CSF examination
(E) Brain biopsy
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