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Confusion Instability of emotions Trouble doing math Forgetfulness/Memory Loss Stubbornness Inability to find items
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Jack RichardsKatarina MayerMakenzie Nelson
CASE #2
Case #2
A 78-year-old man comes to your office with his daughter. The daughter reports that her father, Mark, has been confusing the name of relatives and is having trouble controlling his emotions. Her father was once a respected mathematician, but he is now having trouble completing simple calculations. He even claims that he does not know how to play the card game they have been playing since she was a little girl. She tried to get him to shower and put on clean clothes for the doctor’s visit, but he is adamant about the fact that he is clean. Most recently, he has had trouble recognizing people he has known for years. For quite some time, he has had trouble finding items such as his glasses or keys and his daughter attributed this to the natural aging process. Now she is not so sure.
Patient #2
Symptoms
Confusion Instability of emotions Trouble doing math Forgetfulness/Memory Loss Stubbornness Inability to find items
Hypothyroidism Forgetfulness/
Memory loss Stubbornness Fatigue Muscle Weakness Depression
Possible Diagnoses
Dementia Confusion Instability of
emotions Forgetfulness/
Memory Loss
Stubbornness Inability to find
items
Physical Exam Asks about diet and alcohol
use Reviews all medications Check blood pressure,
temperature, and pulse Listen to the heart and lungs Perform other procedures to
assess overall health
Blood Test Test for hypothyroidism Detects the hormone levels in
the blood stream and can then the function of the thyroid can be determined
Tests for Diagnosis
Mini-Cog Tests for Alzheimer’s and dementia Patient is asked to perform two
tasks Remember and in a few minutes
repeat the names of three objects
Draw a face of a clock and draw the time instructed by the professional there
Mini-Mental State Exam (MMSE) Tests for Alzheimer’s and dementia Maximum of 30 points
20-24 points suggests mild dementia
13-20 points suggests moderate dementia
Less than 12 points suggests severe dementia
With Alzheimer’s, the points decline two to four points per year
Tests for Diagnosis
Blood test was negative for hypothyroidism Alzheimer’s shared the most symptoms with the patient Brain scans, such as a MRI and a CT scan, exhibited multiple
signs of a brain with Alzheimer’s
Actual Diagnosis- Alzheimer’s
MRI
CT
In a brain with Alzheimer's, the brain shrivels up, the hippocampus shrinks, and ventricles become larger.
Cell death and tissue loss in a brain with Alzheimer's contain plaques and dead/dying nerve cells that have tangles (twisted strands of proteins). Plaques are made up of beta-amyloid, a protein, when they clump
together. The tangles and plaques block the synapse from cell-to-cell, thus
disrupting the charges that was being transmitted. Plaques and tangles spread through the cortex.
More about Alzheimer’s
Effects of Alzheimer’s
Alzheimer’s will affect the patient’s life in the ways of Memory loss Language deterioration Impaired perception and spatial relationships Poor judgement
To make the patient feel long term ease, the thought of a home health nurse, a family member monitoring the patient, or the admittance to a nursing home may be few options the family may consider
Prognosis
Perform mental status exams that may include a 20-30 question test, asking standard questions about daily life or current events, drawing/counting items, and monitor ability to perform and complete routine activities
Other exams may test motor reactions, senses, reflexes, coordination, and the cranial nerves
Visits occur every six months or with any decline in memory or any other skills
Medical Professionals: Neurologist
Help clients in their daily personal tasks, such as bathing or dressing Provide basic health-related services according to a client’s needs, such
as checking vital signs or administering prescribed medication at scheduled times
Do light housekeeping, such as laundry, washing dishes, and vacuuming in a client’s home
Organize a client’s schedule and plan appointments Arrange transportation to doctors’ offices or for other kinds of outings Shop for groceries and prepare meals to a client’s dietary specifications Provide companionship
Medical Professional: Home Health Nurse
There are no known cures, but there are options that may help symptoms To help memory loss cholinesterase inhibitors or memantine can be
prescribed To aid behavioral abnormalities antidepressants, anxiolytics, or
antipsychotic medications could be taken
Treatment
Medical College of Wisconsin. (nd.). Alzheimer’s Disease Treatment and Prognosis. [accessed 9 October 2015]. Retrieved from: http://healthlink.mcw.edu/article/921383587.html.
Alzheimer’s Association. (nd.). Treatments for Alzheimer’s disease. [accessed 13 October 2015]. Retrieved from: http://www.alz.org/alzheimers_disease_treatments.asp
Alzheimer’s Association. (nd.). Treatments for Behavior. [accessed 13 October 2015]. Retrieved from: http://www.alz.org/alzheimers_disease_treatments_for_behavior.asp
Everyday Health. (nd.). Assembling Your Alzheimer’s Care Team. [accessed 13 October 2015]. Retrieved from: http://www.everydayhealth.com/alzheimers/alzheimers-care-team.aspx
Alzheimer’s Association. (nd.) Tests for Alzheimer’s Disease and Dementia. [accessed 13 October 2015]. Retrieved from: http://www.alz.org/alzheimers_disease_steps_to_diagnosis.asp
Mayo Clinic. (Dec 1, 2012). Hypothyroidism (underactive thyroid). [accessed 13 October 2015]. Retrieved from: http://www.mayoclinic.org/diseases-conditions/hypothyroidism/basics/symptoms/con-20021179
Medscape. (Jul 27, 2014). Alzheimer’s Disease Imaging. [accessed 13 October 2015]. Retrieved from: http://emedicine.medscape.com/article/336281-overview
National Institute on Aging. (June 2015). Alzheimer’s Disease Medications Fact Sheet. [accessed 13 October 2015]. Retrieved from: https://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-medications-fact-shee
Sources Cited