KFP practice question 7

Mrs Honey Lemon, aged 80, is a long term patient of yours. Her husband passed away a few years ago and she is now living in a retirement village. Her past medical history includes hypertension, hypercholesterolaemia and type 2 diabetes mellitus. She is currently on rosuvastatin, olmesartan and metformin.

Over the past few years, you have noticed that she seems to be a little less organized and keeps forgetting her prescriptions and even has had missed a few scheduled appointments with you.

She came in today to see you for her recent blood tests that you organized recently. Her HbA1c, LFTs and lipid studies have showed some deterioration since last visit. Her FBE, UEC and urine microalbumin however have been normal.

You wonder about her compliance with her medication and she agrees that she has noticed her memory is not as good as it was and she often forgets to take her medication.

You decide to do a MMSE on her and she scored 23 out of 30. You concerned about dementia.

Question 1

What other further investigations are appropriate to follow up on your concerns? List up to five (5).

All the results that you organized above have been within normal limits.

Question 2

What other diagnosis needs to be checked for? One answer only

You decide to refer Honey to the local Cognitive Assessment and Dementia Management Service. You were informed that a diagnosis of Alzheimer’s Dementia has been made.

Question 3

You decided to perform a GP management care plan for her. What important issues need to be addressed in your care plan? List up to eight (8).