A 48-year-old man is evaluated for excessive daytime sleepin…
A 48-year-old man is evaluated for excessive daytime sleepiness. His overnight polysomnography is normal. During multiple sleep latency testing (MSLT), he falls asleep within 4 minutes on average and enters REM sleep during two of the nap trials. He reports no history of cataplexy. CSF hypocretin levels are normal. Which diagnosis is most appropriate?
Read DetailsAn APRN consults on a 78-year-old male admitted to the hospi…
An APRN consults on a 78-year-old male admitted to the hospital three days ago for chest pain. He was diagnosed with heart failure months ago. He is prescribed medications to manage his condition, including lisinopril 20 mg by mouth daily and metoprolol ER 100 mg by mouth daily. The patient has a great deal of time attending to the APRN’s directions and is generally incoherent when spoken to. Recent memory has been getting worse, and he is unable to state correctly where he is. Nurses report that symptoms improve or worsen during different times of the day. His son reports these symptoms were not present prior to hospitalization. Based on presenting signs and symptoms, what condition would be imperative to consider in the differential diagnosis?
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