Decreased Concentration

HISTORY:

Decreased concentration for ‍ ‍hoursdays

Type: ‍difficulty focusingtrouble rememberinginability to stay engaged

Severity: ‍mildmoderatesevere

Negative impact on: ‍workacademic performancedaily tasks

Pattern ‍persistentintermittent

Recent stressors: ‍, ‍work-related issues, ‍personal issues

Treatments tried: ‍none, ‍effectiveineffective

‍decreased productivity

‍difficulty making decisions

‍forgetfulness

‍poor attention span

‍irritability

‍mental fatigue

‍lack of motivation

‍anxiety

‍depressed mood

‍sleep disturbances

‍social withdrawal



EXAM:

General appearance: ‍well-appearing

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Neck: ‍normallymphadenopathy

Heart: ‍RRR, ‍normal S1 and S2

Lungs: ‍clearabnormal sounds, ‍retractions

Neurologic: cranial nerves ‍normal, strength ‍5/5 throughout, sensation ‍normal, reflexes ‍2+ throughout, cerebellar function ‍normal, gait ‍stable

Mental status: ‍alert, ‍oriented, speech ‍clear, mood ‍normal, thought process ‍organized, ‍no suicidal ideation, judgment ‍good



ASSESSMENT:

‍ADHD ‍likelysuspectedpossible

DDx: ‍



PLAN:

- ADHD auto-questionnaire

- Mini-mental state exam

- Blood work: ‍CBC, ‍TSH, ‍electrolytes, ‍creatinine, ‍glucose, ‍vitamin B12

- CT scan of the brain

- MRI of the brain

- Sleep study

- Lifestyle modifications: ‍healthy diet, ‍regular exercise, ‍good sleep hygiene, ‍stress management techniques

- ‍Antidepressants

- ‍Stimulants

- Discontinuation of medications that may cause decreased concentration (antidepressants, sedatives)

- Avoidance of alcohol and recreational drugs

- Cognitive behavioral therapy

- Occupational therapy for cognitive assessment

- Referral to psychologist

- Referral to psychiatrist

- Follow-up in ‍ ‍weeksmonths

- Return if concentration does not improve or if new symptoms develop such as memory loss, confusion, or difficulty with daily activities