Reference no: EM133615112
Mr. Brown is a 72-year-old retired high school teacher who presents today with his daughter. He was referred by his primary care provider, who completed a physical assessment and found no abnormal findings. Lab studies that were faxed to your office included a comprehensive metabolic profile (CMP), a complete blood count (CBC), thyroid-stimulating hormone (TSH), and urinalysis, all of which were unremarkable.
Mr. Brown feels that his daughter is just a "worrier," but his daughter appears rather haggard and explains that her father has been getting "worse" over the past year. She stated that it began with him forgetting to pay bills or losing the car keys-things that she had attributed to normal aging. However, she reports that things are getting worse in that she has entered her father's house on a few occasions to find pans of food burning on the stove because he "forgot" that he was cooking. "One of these days, he's going to burn the house down!" she asserts. She states that she has also found dirty clothing put back into dresser drawers and has found that her father's hygiene has also deteriorated. "If I don't remind him to take a shower, he wouldn't!"
After your initial assessment, you find that Mr. Brown demonstrates impairment in at least two neurocognitive domains.
His daughter was somewhat upset at a suggestion for HIV antibody testing as she states, "My father was never a drug addict!" Additionally, she states that she is uncertain as to whether anybody in the family ever had Huntington's disease. She does know that her father had a sister who died in her 20s, but she is not sure what happened as he never spoke about it.
One Month Later
Mr. Brown returns to your office a month later after MRI testing was approved by his insurance company and completed. In reviewing the report, you find the following information:
Impression:
- Cerebral amyloid angiopathy (CAA)
- Multiple cortical infarcts noted
- Clinical correlation is recommended
Question:
Based on the above information, what would be the most appropriate diagnosis for Mr. Brown? Be sure to justify your response with proper research evidence.