QuestionSBA
QuestionChoice
This is correct. This scenario describes normal pressure hydrocephalus for which the treatment is to insert a ventriculoperitoneal shunt to relieve the hydrocephalus, which tends to reverse the symptoms. NPH patients present with polyuria, confusion, rapidly progressive dementia with gait abnormalities.
10028431
a
Ventriculoperitoneal shunt
QuestionChoice
These represent treatment options for Parkinsonism which would present with bradykinesia, shuffling gait and rigidity.
10028434
d
L- Dopa & medication review
QuestionChoice
This may be indicated in cases of metastatic brain cancer but is not appropriate here as NPH is more likely due to absence of headaches and focal neurology.
10028435
e
Palliative care
QuestionChoice
This is an option in various mental health diagnoses and may be used to treat symptoms of depression and anxiety that often arise in patients with dementia.
10028433
c
Cognitive behavioural therapy
QuestionChoice
This is an option in Alzheimer's dementia, which is not the case here.
10028432
b
Donepezil
QuestionComment
wet,wobbly,weird
43049
User
subscriber
CT Kawasaki
QuestionComment
Isn't the wet referring to urinary incontinence the stem sounds like polyuria 
48663
QuestionComment
In the explanation, it does say "polyuria", but the triad is classically: gait ataxia, urinary or faecal incontinence, and dementia.
60711
User
subscriber
Amnesia Contusion
User
subscriber
Edema Dominant
Concept
Chapter
2693
4550
Normal pressure hydrocephalus
Topic
141
Neurology
18084
Normal pressure hydrocephalus presents with confusion, gait abnormalities, and polyuria, often improving with ventriculoperitoneal shunt placement.
A 72 year old man has been increasingly confused for the last few months. He has become increasingly forgetful and has had several falls. He describes feeling more thirsty and urinating more frequently over the same timeframe.

Which of the following is the best management option, given the likely diagnosis?
a