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Patient Case 1

                                                    

Date of Presentation: 07/22/2021

64W     Employed

🖨

DST Recommendations: Aifred Health

Treatment Names Chance of Remission
Induction therapy with Intravenous Cyclophosphamide 86%
3 doses Cyclophosphamide (q. month) + 1 tapered Oral Prednisone course 75%
Intravenous Methylprednisolone 70%
Oral Doxycycline 62%

Patient Information

Basic Information
DX Cerebral amyloid angiopathy–related inflammation. SX Cognitive impairment, headache, and memory loss
FH A major depressive episode ALGY Allergic to Amoxicillin–clavulanate with an unknown reaction

Current Medications
Atorvastatin, Levothyroxine, Sertraline, Vitamin B12, and Cholecalciferol. ➕

The patient had a history of poliomyelitis in childhood, with residual mild weakness in the left leg; vitamin B12 deficiency, which had been corrected; and hypothyroidism.


Other Information
Former smoker with a 40 pack-year history, and she had consumed four alcoholic beverages per week before the onset of the current illness.

Examination Result
6 Examination Results: ➕

• The temperature: 36.7°C,
• blood pressure: 105/51 mm Hg,
• heart rate: 56 beats per minute,
• respiratory rate: 16 breaths per minute,
• oxygen saturation: 96% while she was breathing ambient air.
• body-mass index (the weight in kilograms divided by the square of the height in meters): 32.4.

Literature Evidence

Please click literature names for PICO summary, or enter PICO keywords to filter out literature you interested.

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Below table displays the matchable literatures from PubMed and Google Scholar filtered by patient's SX.

Literature Names Year

There is evidence that migraine is associated with cognitive impairment years before a migraine diagnosis. In young and middle-aged adults, migraine is associated with deficits in attention, executive function, processing speed, and memory. It is unlikely that migraine is associated with dementia.

 (2022)

Elevated intracranial pressure headache and emotional distress can contribute to reduced cognitive performance and increased self monitoring.

 (1997)

Cognitive impairment is a common symptom in patients with stress-related exhaustion, and is most pronounced in executive function, attention span, and working memory. The severity of burnout symptoms is related to poorer performance on tests of learning and memory.

 (2012)

The RBMT can be used to accurately diagnose mild cognitive impairment in patients. However, prospective memory tasks are not useful for detecting these patients.

 (2005)