All right. Welcome. My name is Devine. This is episode 443 of the Devine

Intervention Podcasts. And to these podcasts we're going to be talking about

acetylcholinesterase inhibitors. We're going to be talking about acetylcholinesterase

inhibitors. This is a topic that's pretty high yield. It's tested in many different contexts on exams, step one, step two, step three.

So it's something you want to make sure you understand.

So let's start off with a question.

What if you get a question about an 85 year old female. They tell you that for the last six months her daughter has noticed that she is beginning to forget what her name is.

She has to be constantly reminded of things

she previously knew well before.

She is having trouble coming back from the store on her own.

She has had to you know the police has had to be called multiple times because she

has missed her way back home.

And then they tell you that at a mini mental status exam,

this person's score was like 20 over 30.

Our friends at the US

at the US families will try to put an answer that says mild cognitive impairment,

but another answer they're going to put is Alzheimer's.

Or they may kind of hope that you realize it's Alzheimer's and then they'll see which of the following is the most likely additional finding in this patient.

They can put things like dysfunction of the basal nucleus of minor, which is true in Alzheimer's, because you know, in Alzheimer's,

we have lost low calling and that comes because you have dysfunction of the basal nucleus of minor.

They can just put many different things. They can put like

poor blood supply in the brain, which would be more vascular dementia. they can put accumulation of bitter amyloid plaques, which will be

...