Issue

CASE PRESENTATION
Mr. J is a 59-year-old married man who is the vice president of a large accounting firm. He comes to see his internist accompanied by his wife. Mrs. J tells Dr. G that she is extremely concerned about her husband. He has been forgetful at times, such as eating dinner and then coming to her an hour later asking, “What’s for dinner?” She reports that her husband, a usually quiet man, has been talking to strangers, often carrying on long conversations about small details, such as whether the price of postage stamps is too high. Mr. J has been socially inappropriate at ti

Monoclonal gammopathy of undetermined significance (MGUS) occurs with the uncontrolled proliferation of plasma cells from a single clone in the absence of clinical disease. These plasma cells secrete homogeneous immunoglobulins that are detected in serum or urine protein electrophoresis as a monoclonal protein (M protein). Monoclonal gammopathy of undetermined significance occurs in about 0.15% of the general population and is concentrated mainly among older persons.1 In a study of 7000 subjects with MGUS in Malmo, Sweden, there was a prevalence of 2% in those 70-79 years of age and a 5.7% pre

ACCREDITATION
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

CREDIT DESIGNATION STATEMENT
The Johns Hopkins University School of Medicine designates this educational activity for a maximum of 1.0 category 1 credit toward the AMA Physician’s Recognition Award. Each physician should claim only those hours of credit th

This continuing medical education activity is sponsored by the Johns Hopkins University School of Medicine, Baltimore, Maryland. The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.

These examination questions are based on the article “Psychostimulants in the Treatment of Depression in the Older Patient,” which appears on pages 39-45 in this issue of Clinical Geriatrics.

ACCREDITATION
The Johns Hopkins University School of Medicine is accredited by the Accreditation Council for Continuing Med

We continue to see an increase in the average life expectancy in the United States, and we are proud of this accomplishment. Obviously we are doing something “right.” The average lifespan is defined as that age to which a baby born today can expect to live, based on actuarial data that estimate when 50% of those born in a given year can expect to live beyond. Data from 2003 recently issued by the Centers for Disease Control and Prevention listed 77.6 years as the average lifespan for a baby born that year, a rise of 0.3 years over that recorded just one year prior. This represents a 1.7% d

A stroke occurs when a blood vessel breaks or when a blood clot blocks a blood vessel or artery. This interrupts blood flow and destroys brain cells in the immediate area; this area of dead brain cells is known as an infarct. After these cells die, chemicals are released, affecting brain cells in the surrounding area of brain tissue where blood supply is compromised. Symptoms of a stroke include numbness or weakness, usually on one side of the body in the face, arm, or leg; confusion, trouble speaking, or understanding; difficulty seeing in one or both eyes; trouble walking, dizziness, loss of