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NEW PATIENT WITH DEMENTIA - Coggle Diagram
NEW PATIENT WITH DEMENTIA
Basic Criteria:
MILD testing c/w MCI or mild AD (MMSE 24 and up)
MCI or early AD with minimal impact on day to day life.
Otherwise healthy
Exclusion:
Anticoag or bleeding DO.
Cannot get MRI.
Stroke/TIA in last year
unstable psychiatric or medical illness like
uncontrolled HTN or DM, HIV, renal, liver dysfunction.
Brain hemorrhage, other CNS disorder.
Any reason in the opinion of the physician the patient cannot tolerate infusion, appointments, MRIs, amyloid scan.
Excluded: if able to identify barrier and overcome, can consider re-evaluation.
Wu and treat at physician discretion.
Correctable or clear AD DX? If yes, re-evaluation.
If no, then NOT ELIGIBLE to receive drug.
Able to move forward
MRI
Blood Work
Abnormal. B12 deficiency, abnormal thyroid function
NORMAL for age.
Amyloid Screen
+ AMYLOID
DOSE
READY
2 more items...
-
Discussion, consider second amyloid screen
SECOND AMYLOID SCAN
2 more items...
Not amyloid, no treatment
ABNL MRI: Acute or sub-acute hemorrhage. Prior macrohemorrhage (1 sq cm or more, prior subarachnoid hemorrhage WITH risk of recurrent hemorrhage). 5 or more microhemorrhages on T2* sequence. Cortical infarct >1.5 cm in diameter. lacunar infarct >1.5 cm. Superficial siderosis. Highly significant white matter disease
KNOWN: substance abuse, stroke or other cerebrovascular condition giving rise to cognitive changes, DX Lewy body dementia, fronto-temporal dementia, PSP, CJD, TBI, significant psychiatric illness, normal cognition.