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NBME 21 Answers

nbme21/Block 4/Question#38 (27.5 difficulty score)
A 62-year-old woman is brought to the ...
Instruct the patient to keep notes and lists to help her memory🔍

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The researchers found that people who participated in mentally challenging activities most often, both early and late in life, had a slower rate of decline in memory compared to those who did not engage in such activities. Even when people had plaques and tangles and other signs of damage to their brains, mental stimulation seemed to help protect memory and thinking skills, accounting for about 14 percent of the difference in decline beyond what would be expected (Prashanthi Vemuri, PhD, Elizabeth C. Mormino, PhD: “Cognitive Stimulating Activities to Keep Dementia at Bay.” Neurology, Vol 81. 2013)

also the way i see it, AD pts have problems with hippocampus (i.e. short term memory power house) so keeping notes and lists or whatevvaa might help slow their cognitive decline as theyll be keeping the hippocampus more active

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submitted by niboonsh(280),
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i tgo htsi ntquesio ithgr tub hyw toulcnd ti be kingo iobalb?

nor16  and why no therapy, i.e. cognitive training` +  
jessica_kaushal  first step is to make the patient's environment accomodating for the patient. +1  
jessica_kaushal  first step is to make the patient's environment accomodating for the patient. +  
tryntofigritout  Because this is a western medicine test. Even though it has shown great protection against AD and memory protection, this test won't allow that. I initially clicked on ginko but thought to myself... na this test doesn't accept an eastern idea. so clicked on the one I know they wanted me to say, and I got it right. ha +5  
mumenrider4ever  Wikipedia says "Gingko extract has also been studied in Alzheimer's disease, but there is no good evidence that it has any effect." +1  

Not sure what the implication was regarding the assisted living facility (I never thought of them as a last resort situation), because it has been shown that social activities are incredibly beneficial in slowing down the progression of dementia. I suppose she is in the early stages of disease and doesn't warrant anything so drastic like moving just yet.