CASE #2

Jack Richards
Katarina Mayer
Makenzie Nelson

Patient #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 doctors 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.

Symptoms

Confusion
Instability of emotions
Trouble doing math
Forgetfulness/Memory Loss
Stubbornness
Inability to find items

Possible Diagnoses

Dementia
Confusion
Instability of
emotions
Forgetfulness/
Memory
Loss
Stubbornness
Inability to find
items

Hypothyroidis
m
Forgetfulness/
Memory loss
Stubbornness
Fatigue
Muscle Weakness
Depression

Tests for Diagnosis

Blood Test
Test for hypothyroidism
Detects the hormone
levels in the blood
stream and can then
the function of the
thyroid can be
determined

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

Tests for Diagnosis

Mini-Mental State Exam

(MMSE)
Tests for Alzheimers 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 Alzheimers, the
points decline two to four

Mini-Cog
Tests for Alzheimers 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

Actual Diagnosis- Alzheimers

Blood test was negative for hypothyroidism

Alzheimers shared the most symptoms with the
patient
Brain scans, such as a MRI and a CT scan,
exhibited multiple signs of a brain with
Alzheimers

MRI

CT

Effects of Alzheimers

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 Alzheimers

Prognosis

Alzheimers will affect the patients 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

Medical Professionals: Neurologist

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 Professional: Home Health

Nurse

Help clients in their daily personal tasks, such as bathing or dressing

Provide basic health-related services according to a clients 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 clients home
Organize a clients schedule and plan appointments
Arrange transportation to doctors offices or for other kinds of outings
Shop for groceries and prepare meals to a clients dietary
specifications
Provide companionship

Treatment

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

Sources Cited

Medical College of Wisconsin. (nd.). Alzheimers Disease Treatment and Prognosis. [accessed 9 October
2015]. Retrieved from: http://healthlink.mcw.edu/article/921383587.html .
Alzheimers Association. (nd.). Treatments for Alzheimers disease. [accessed 13 October 2015].
Retrieved from: http://www.alz.org/alzheimers_disease_treatments.asp
Alzheimers 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 Alzheimers Care Team. [accessed 13 October 2015]. Retrieved
from: http://www.everydayhealth.com/alzheimers/alzheimers-care-team.aspx
Alzheimers Association. (nd.) Tests for Alzheimers 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/con20021179
Medscape. (Jul 27, 2014). Alzheimers Disease Imaging. [accessed 13 October 2015]. Retrieved from:
http://emedicine.medscape.com/article/336281-overview
National Institute on Aging. (June 2015). Alzheimers Disease Medications Fact Sheet. [accessed 13
October 2015]. Retrieved from: https://
www.nia.nih.gov/alzheimers/publication/alzheimers-disease-medications-fact-shee