TABLE 16-2 - ROUTINE SCREENING EVALUATION FOR THE DEMENTED PATIENT
| Test |
Indication |
| Complete blood cell count |
Anemia; polycythemia; vitamin B12 deficiency (hypersegmentation) |
| ESR |
Vasculitis; tumor; infection |
| VDRL & FTA-ABS |
Syphilis (in tertiary syphilis, serum VDRL may be negative and FTA positive) |
| Blood sugar |
Hypo- or hyperglycemia |
| Blood urea nitrogen |
Renal Failure |
| Electrolytes |
Water intoxication; Adrenal disease |
| Calcium/Phosphorus |
Hyper- or hypocalcemia; hypophosphatemia |
| Antinuclear antibody |
Vasculitis |
| Protein electrophoresis |
Hyperviscosity syndrome from paraproteinemia |
| T4/TSH |
Hyper-or hypothyroidism |
| Cortisol |
Cushing disease |
| Serum B12/Folate |
Pernicious anemia |
| Ascorbate/Carotene |
Malabsorption; Malnutrition |
| Cholesterol/triglycerides |
Hyperlipidemic dementia |
| Liver function tests |
Hepatic encephalopathy; Metastases |
| Arterial blood gases |
Acidosis; Anoxia |
| Lyme titer |
Lyme disease |
| EEG |
Slowing or triphasic waves (in most metabolic encephalopathies); focal abnormalities (such as strokes or tumors); constant seizure activity. |
| CT scan or MRI |
Mass (neoplasm, subdural hematoma, etc), inflammatory process, stroke, hydrocephalus |
| Lumbar puncture: evaluation of protein, glucose, cells, culture, VDRL, fungus, electrophoresis, IgG synthesis ratio, etc. |
(if not contraindicated): Inflammatory disease; infection; hydrocephalus |