Reference no: EM133755805

Question

A 61-year-old man presents for evaluation. He and his family members have noticed that he has experienced a significant gradual decline in cognitive functioning over the past year, and a recent neuropsychological test confirmed marked impairment. Additionally, he has become increasingly disinhibited, apathetic, and unsympathetic. Normally a social person, he has recently lost close friends. His work as an accountant has suffered and he has considered early retirement. He has no history of a psychotic, mood, or anxiety disorder. His medical history is notable for hypertension, hyperlipidemia, and diabetes for which he is treated with lisinopril, amlodipine, atorvastatin, and metformin. He does not smoke or drink alcohol. He does not use drugs. On physical examination, temperature is 98.8°F, blood pressure 137/87, pulse 73, respiratory rate 16. 5/5 strength and sensation are appreciated on flexor and extensor muscle groups in the upper and lower extremities. Memory and recall are intact on mini-mental status exam. Of the following, which is most likely to be appreciated on brain magnetic resonance imaging? Atrophy of the fronto-insular region Atrophy of the medial temporal region Multiple generalized white matter lesions Volume loss in basal ganglia.