LMSW Practice Test

A 38-year-old client with a history of chronic alcoholism develops short-term memory loss, compensates by inventing stories, and seems confused and disoriented. The most likely diagnosis is

1. Alzheimer's Disease

2. Korsakoff's Syndrome

3. psychogenic amnesia

4. Tardive's Dyskinesia

The correct answer is: Alzheimer's Disease

The most likely diagnosis for the client described is Korsakoff's Syndrome. This condition is a neurological disorder caused by a deficiency in thiamine (vitamin B1), often associated with chronic alcoholism. The symptoms of short-term memory loss and the tendency to fill in memory gaps with invented stories, known as confabulation, are classic presentations of Korsakoff's Syndrome. Additionally, individuals with this syndrome may experience confusion and disorientation. While Alzheimer's Disease does lead to memory impairment, it typically presents with a gradual decline in cognitive function, starting with recent memory loss and progressing to more severe cognitive deficits. In contrast, Korsakoff's Syndrome is characterized by its acute onset related to alcohol use and nutritional deficiencies. Psychogenic amnesia involves memory loss typically linked to psychological stress or trauma, rather than a neurological condition stemming from nutritional deficiencies. Tardive Dyskinesia is a movement disorder related to long-term use of antipsychotic medications and does not correlate with the memory issues and confabulation described. Understanding the context and characteristics of Korsakoff's Syndrome helps clarify why it is the most appropriate diagnosis in this situation.