FORGETFULLNESS AND CONFUSION: HVV,NSsALD

OPDF

HVV,NSALD

Hypothyroidism? (Cold Intolerance)

a. Have you noticed any changes in skin?
b. Have you noticed any changes in bowel movement?

Vitamin B12 Deficiency (prior resection of ileum):

a. What does your primary diet comprises of?
b. Have you noticed any abnormal sensation in your hands or feet(tingling)?

Vascular Dementia (Hx of Stroke, MI,HTN stepwise cognitive decline):

a. Have you noticed any Weakness, Numbness or Tingling of your body?
b. Have you noticed any difficulty with speech?

Normal Pressure Hydrocephalus:

Any difficulty walking?
Have you ever passed urine accidently/unintentionally?

Chronic Subdural Hematoma:

Lightheadedness or feeling faint or Passing out? shaking or seizures after that?
Do you have any recent Hx of fall or trauma to head?

Subacute spongiform encephalopathy(SSE)/ Creutzfeldt-Jakob disease: rapidly progressive change

in mental status, inability to concentrate, and memory impairment,myoclonus, ataxia.

Alzheimers Dementia: (Age, Family Hx,steady, progressive decline in cognitive function over a period of
years)
Have you noticed any problem performing your daily activities e.g. bathing, dressing, cooking, Shopping,
Paying the bills, getting in and out of the bed and chair etc.?

Lewy Body Dementia:

a. Have you noticed any tremors in your hands?
b. Have you noticed any stiffness of your body?
c. Have you noticed any slowing of your body movements?

Depression: (Mood + SIGECAPS); (Dementia syndrome of depression)

a. How is your mood these days?
b. Have you noticed any changes in your Sleep? If yes, ask about early morning awakening? Trouble
falling sleep? Staying Sleep?
c. Do you enjoy the activities that you used to enjoy previously? (Interest)
d. Do you feel Guilty about anything?
e. Do you feel as Energetic as before?
f. Concentration Qs? Serial 7s or spell backwards.
g. Have you noticed any change in your Appetite?
h. Psychomotor retardation?
i. Have you ever thought about Suicide? Have you ever planned or attempted suicide?

Delirium: Ask Dehydration Qs (Heat stroke or Diarrhea):

Sudden onset and fluctuation of symptoms are key findings in delirium.
Delirium is usually reversible because unlike dementia, delirium is usually due to a
problem that can be identified and treated.
Speech in a patient diagnosed with delirium is often rambling or incoherent, whereas
speech in a patient diagnosed with dementia may be limited or aphasic.
Attention in delirium is impaired, whereas attention in dementia is not impaired until late
stages of the disease.
FATIGUE:

M3A2D3HP

Myasthenia Gravis:
a. How does it progress during the day?
b. Have you noticed weakness of muscles or double vision?

Multiple sclerosis: limb weakness, numbness, tingling, blurry vision, diplopia, urinary retention, vertigo,
symptoms may wax and wane.

Malignancy (occult): (WA,WF,UB,NVCD)

a. Have you noticed any pain in your belly?

Apnea:
a. Do you snore at night? Or has someone told you?
b. Do you feel sleepy during the day?

Anemia:
a. Have you noticed any change of skin color?
b. Have you noticed SOB on exertion?
c. Have you noticed any bleeding from any site of the body(blood in stool,mensturation)?

Depression: (Mood + SIGECAPS)

Mood: feeling sad/depressed

SIGECAPS

Suicidal thoughts/plans/attempts

Diabetes Mellitus /Diabetes insipidus (DI)::

a. Do you feel more thirsty than usual?
b. Do you have to urinate more frequently than usual?
c. Idiopathic or acquired (eg, posthead trauma, benign tumors, or surgery)

Domestic violence(SSEAT):
a. Feeling Safe / afraid at home?
b. Self-blame, defend husband
c. Emergency plan?
d. Have u been physically or emotionally hurt or Abused by anybody? Are the children being abused or
threatened? Have u ever received Trauma from your husband?

Hypothyroidism :(BVW,CS)
Change in Bowel habits
Voice change
Weight changes
Cold intolerance
Skin/hair changes

PTSD/ Adjustment: (Stress/ Trauma)

a. Have you experienced nightmares recently?