医学专业英语课件2.pptx
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1、2023年4月23日星期日医学专业英语课件医学专业英语课件_2。 Mini Mental Status Examination gives a score of 18 out of 30. The head and neck and cardiovascular examination are unremarkable. Abdomen is benign without hepatosplenomegaly. The extremities are without edema, cyanosis, or clubbing. The neurologic examination reveals
2、 that the cranial nerves are intact, and the motor and sensory exams are within normal limits. Cerebellum examination is unremarkable and the gait is normal.Alzheimer dementia. Assess for depression and reversible causes of dementia. Acetylcholinesterase inhibitor Analysis12Table 49-1ABBREVIATED WOR
3、KUP FOR DEMENTIAComplete blood count and consider erythrocyte sedimentation rate (ESR) Chemistry panel Thyroid-stimulating hormone level Venereal Disease Research Laboratory (VDRL) HIV assay Urinalysis Serum vitamin B12 and folate levels Chest radiographElectrocardiogram CT or MRI imaging of the hea
4、d 12 APPROACH TO DEMENTIAnMultiinfarct dementia: Numerous small cerebral vascular accidents, most commonly caused by atherosclerotic disease, leading to dementia.nNormal pressure hydrocephalus: Reversible form of dementia where the cerebral ventricles slowly enlarge as a result of disturbances to ce
5、rebral spinal fluid resorption. The classic triad is dementia, gait disturbance, and urinary or bowel incontinence.Table 49-2NEUROLOGICAL DISEASES IMPAIRING COGNITIVE ABILITYDISEASE CLINICAL FEATURES TREATMENT Alzheimer disease Slow decline in cognitive and behavioral ability; pathology: neurofibril
6、lary tangles, enlarged cerebral ventricles, and atrophy Cholinesterase inhibitors such as donepezil or rivastigmine Normal-pressure hydrocephalus Gate disturbance, dementia, incontinence; enlarged ventricles without atrophy Ventricular shunting process Multi-infarct dementia Focal deficits, stepwise
7、 loss of function; multiple areas of infarct usually subcortical Address atherosclerotic risk factors, identify and treat thrombus Parkinson disease Extrapyramidal signs (tremor, rigidity), slow onset Dopaminergic agents Table 49-2 (cont)NEUROLOGICAL DISEASES IMPAIRING COGNITIVE ABILITYDISEASE CLINI
8、CAL FEATURES TREATMENT HIV defintion Systemic involvement; risk factors for acquisition; positive HIV serology Treat specific infection Neurosyphilis Optic atrophy, Argyll-Robertson pupils, gait disturbance; positive cerebro-spinal fluid serology High dose intravenous penicillinMultiple sclerosis Br
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