Match each clinical vignette with the most likely underlying neurocognitive diagnosis.
- A 73-year-old woman experiences an insidious, progressive decline in her short-term memory over three years, initially struggling to recall recent conversations, with no focal motor deficits on examination.Alzheimer disease
- A 59-year-old woman exhibits socially inappropriate behavior, profound apathy, and diminished hygiene over the past year, while her performance on spatial and memory tasks remains relatively intact.Frontotemporal dementia
- A 68-year-old man presents with well-formed visual hallucinations of children playing in his room, fluctuating periods of confusion, and resting tremor with rigidity in his upper extremities.Lewy body dementia
- A 76-year-old man has a history of multiple transient ischemic attacks and now presents with a stepwise deterioration in executive functioning and asymmetric deep tendon reflexes.Vascular dementia
- A 78-year-old man develops a slow, wide-based, shuffling gait, new-onset urinary incontinence, and slowed mentation without prominent cortical signs.Normal pressure hydrocephalus
Cevap
The correct matches align each clinical vignette with its signature presentation: the patient with insidious memory loss has Alzheimer disease, the patient with behavioral changes has frontotemporal dementia, the patient with hallucinations and parkinsonism has Lewy body dementia, the patient with stepwise decline has vascular dementia, and the patient with gait impairment and incontinence has normal pressure hydrocephalus.
Each neurocognitive disorder has a distinct clinical signature. Alzheimer disease classically presents with insidious, progressive memory loss. Frontotemporal dementia features early behavioral and personality changes. Lewy body dementia is characterized by recurrent visual hallucinations, fluctuating alertness, and parkinsonism. Vascular dementia follows a stepwise decline temporally related to cerebrovascular events, often with focal neurologic deficits. Normal pressure hydrocephalus presents with the characteristic triad of magnetic gait, incontinence, and cognitive slowing.
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Differential Diagnosis of Major Neurocognitive Disorders
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