Functional Decline Over 18 in Medicine / Internal Medicine — 80yo Man | Neurology | SMLE Q#11588
SMLE Question #11588
Medicine / Internal Medicine
Neurology
Objective: OBJ-307
Last updated: February 2026
An 80-year-old man has worsening memory for 2 years with functional decline over 18 months. His cognition deteriorates abruptly after episodes of transient right-hand weakness and slurred speech that resolve within hours. He has untreated long-standing hypertension. He struggles with finances and frequently gets lost. He is oriented to person but not to date; MMSE is 20/30. Neurologic examination shows right pronator drift, mild right arm spasticity, brisk right-sided reflexes with an extensor plantar response, and a broad-based unsteady gait. What is the most likely diagnosis?
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