Cognitive impairment

? Multiple Choice Questions Section The Neurosciences Journal includes this section of multiple choice questions as part of its commitment to continuous education and learning in Neurosciences. Experts in various neuroscience specialties are invited to participate with their knowledge and expertise in this section. Neurology, neurosurgery, and other board residents are encouraged to read this section to improve their knowledge and direct their reading for written examinations. Choose the most appropriate single answer. 1. A 65-year-old male presents with a 2-year history of forgetfulness. He needed to make more reminder notes and alerts on his smart phone to be on schedule. He is in charge of managing a small business, and noticed he cannot easily recall the names of new clients. Otherwise, the business is running well, and his decisions remain sound. His family and colleagues have noticed his struggles with recall but there have not been any changes in his performance. There was no significant past medical or surgical history. His mother had dementia in her senior years before she died from pneumonia. The neurological exam was normal including a full score on the Mini-Mental State Exam. On the Wechsler memory scale, he scored slightly lower than the controls and additional neuropsychological assessments revealed normal performance of the remaining cognitive domains. What is the most likely diagnosis? a. Mild Alzheimer's dementia b. Mild cognitive impairment c. Pseudo-dementia secondary to depression and work related stress d. Cognitive changes associated with aging 2. A 70-year-old woman with hypertension is referred by the family physician due to progressing memory complaints over the past 18 months. Her older sister died with Alzheimer's disease 2 years earlier, and worries she will develop the same fate. After a thorough neurological evaluation, the diagnosis is amnestic-mild cognitive impairment. Her MRI was normal. What is her risk of converting to Alzheimer's disease? a. 5-15% conversion rate over 5 years b. 20-40% annual conversion rate c. 5-15% annual conversion rate d. <1% with a normal MRI 3. A 70-year-old retired engineer with a previous history of diabetes and a transient ischemic attack one year earlier is seeking a second opinion about his cognitive problem. He had recently seen a physician who diagnosed him with amnestic-mild cognitive impairment and advised him to stay involved in social and other cognitive activities in addition to tight blood sugar control and regular exercise. What does current evidence recommend about management at this …