You are seeing a 50 something old man.

He has hx of high BP and on the medication ( cant remember what it is )In the past he was not really compelling with his follow up and tx. Recently, hes been acting strangely, the wife complained there was one day when suddenly he changed the line while driving and almost caused accident. His daughter was also upset with him, when she left the kids with him, he seems careless. You did MMSE before ( I think 1 week b/fore) and the result was abnormal ( the result was given in the exam, I cant remember, please ask with other candidates) Task: Take further Hx Do cognitive examination and other examinations that you think necessary, no need to repeat MMSE unless its specifically needed and necessary Give your D/ to examiner and the reasons and DD/, What Ix you want to do This was hard, patient kept talking non stop, and not answering the Qs straightforward but going around sometimes even not answering the Qs specifically . I did do well, as I spent too much time with the patient, I felt reluctant to interrupt him in the middle, but actually when you interrupt him and asking Qs, he listened and stop talking. I spent 6 minutes with him as the examiner told me Ive got 2 minutes last so I jumped telling examiner my d/ and the reasons and even not touching the Ix as the times up On hx, he said has BP long time ago, not remember when the last time have it check, sometimes take medication, sometimes dont as he feels healthy, no problem. No headache, blurring vision, pins needles, never had chest pain, not drinking too much, only occasionally, cant remember if the patient smokes or not( I spent too much time with this, because first I thought it was a medicine case and remember the patient not answering the Qs shortly but talking around b/fore go to the point ) When asked what happened actually why he suddenly changed the line, he said his wife was overreact, nothing serious happen, when asked about his daughter complain, he answered they just spoil the kids a lot, you know this time all kids get what they want, I asked him specifically what happened, any accident with the grandkids, hes still like that, kept saying nothing happened, they just overreact and spoil the kids too much ( so I dont know whats really the problem)I asked whether he ever had stroke or sudden weakness on 1 side of the body, he said no. I asked him whether he seemed to be forgetful recently like putting the key few minutes ago but then cant remember ? He basically not answering my Q so I decided to ask him to tell me where he is now, he answered, well Im now talking to you, I suppose its in the hospital. When I asked him to tell me whats the date and day for today, he couldnt do it, He also had problem with recalling 3 object, only can repeat 1. I did not continue asking MMSE as in the task its said unnecessary to repeat it unless it specifically needed. I tried to rule out depression by asking his mood which is ok, feels happy, no stressful event or loss in his life. He didnt feel that he has problem at all. The last 2 minutes I told examiner most likely he has dementia and the DD/ is depression and I explained the reasons and times up