Alzheimer

Case
A 75-year-old white man presents for a health maintenance checkup.The patient has stable hypertension but has not seen a
physician in more than 2 years. He denies any particular problems.
He lives alone. He takes an aspirin a day and is compliant with his
blood pressure medication (hydrochlorothiazide). His son fears that
his father is either experiencing a stroke or getting Alzheimer
disease because his father is having trouble with speech
discrimination and understanding what family members are saying
during social events. The son reported no noticeable weakness or
gait impairment. On physical examination, the patients blood
pressure was 130/80 mm Hg. Examination of the ears showed no
cerumen impaction and normal tympanic membranes. His general
examination is normal. Laboratory studies, including thyroidstimulating hormone (TSH), are normal.(18)

Key words

A 75-year-old white man

Maintenance check-up
Hypertension more than 2 years
takes an aspirin and hydrochlorothiazide
having trouble with speech discrimination and
understanding what family members are saying
during social events
blood pressure was 130/80 mm Hg
ears showed no cerumen
including thyroid-stimulating hormone (TSH), are
normal

Admission form
SURNAME : UDIN FIRSTNAME : NINGRAT
AGE : 75-year-old SEX :MALE
MARITAL STATUS : SINGLE
OCCUPATION : PRESENT COMPLAINT :
1. A 75-year-old white man
2. hypertension more than 2 years
3. having trouble with speech discrimination
and understanding what family members are
saying during social events (a fasia)

O/E

GENERAL CONDITION : ENT

: NORMAL
RS
: NORMAL
CVS
: pressure was 130/80
mm Hg
GIS
: NORMAL
GUS
: NORMAL
CNS
: NORMAL

 IMMEDIATE PAST HISTORY : POINTS OF NOTE

: He takes an
aspirin a day and hydrochlorothiazide
INVESTIGATIONS
: NORMAL
DIAGNOSIS
: Alzheimer

QOESTION LIST
ENT Ear : I want you turn your head
this way
Nose :Please, tit your head back
Throat :Open your mouth
CVS :I wanna check your blood
pressure and pulse
CNS : Are you understood what I say?
Can you repeat what I say?

DEFINITION
Alzheimers (AHLZ-high-merz) is a disease of
the brain that causes problems with memory,
thinking and behavior. It is not a normal part of
aging. Alzheimers gets worse over time.
Although symptoms can vary widely, the first
problem many people notice is forgetfulness
severe enough to affect their ability to function
at home or at work, or to enjoy lifelong
hobbies. The disease may cause a person to
become confused, lost in familiar places,
misplace things or have trouble with language.

Signs and symptoms

1. Worsened ability to take in and remember new
information, for example:
"Repetitive questions or conversations
Misplacing personal belongings
Forgetting events or appointments
Getting lost on a familiar route."
2. Impairments to reasoning, complex tasking,
exercising judgment:
"Poor understanding of safety risks
Inability to manage finances
Poor decision-making ability
Inability to plan complex or sequential activities."

 3. Impaired visuospatial abilities (but not, for

example, due to eye sight problems):
"Inability to recognize faces or common objects or to find
objects in direct view
Inability to operate simple implements, or orient clothing to
the body."
4. Impaired speaking, reading and writing:
"Difficulty thinking of common words while speaking,
hesitations
Speech, spelling, and writing errors."
5. Changes in personality and behavior, for example:
Out-of-character mood changes, including agitation; less
interest, motivation or initiative; apathy; social withdrawal
Loss of empathy
Compulsive, obsessive or socially unacceptable behavior

Treatment
Treatment: Comorbid Medical
Conditions
Treatment: Palliative and End-of-Life
Care

Hatur thanks pisannnn:D