1 of 2Case Study – Alzheimer’s Disease
Objectives
1. Explain the risk factors, symptoms, etiology, progression, diagnosis, treatment and
prognosis.
2. Demonstrate the ability to access and critically evaluate information from a wide
variety of sources (such as Library databases and internet sources).
Read the case presentation and answer the questions that follow. The Case Study
Rubric will be used to assess your work. The Case Study rubric lists the criteria for each
question (required resources, word counts and citation requirements).
Case Presentation
A 83 year old woman, Mary, was brought for neurological evaluation by her brother
because of a 3 year history of memory impairment. She completed high school and
worked in a clerical position until her retirement in 2005. She had lived alone and
maintained her own home and financial affairs since the death of her husband in 2010.
She did not have any children. The brother had begun to notice gradually worsening
memory impairment and difficulty finding words, but the patient became angry at the
suggestion that she may have memory loss. Other friends and family members noted a
decline in socializing and in her housekeeping. Her brother is concerned that she has
dementia.
Mary’s speech had a tendency to use vague references such as “things” and “stuff”.
She was able to provide her name, but when asked about her current age she said, “I
don’t know…about 12 I think”. She was unable to give the year of her birth, the current
year, or the name of the current U.S. President. On formal testing, General Practitioner
Assessment of Cognition (GPCOG) and Mini-Cog, she scored well below average in all
cognitive domains.
The physician explained to Mary’s brother that all patients suspected of Alzheimer’s
should have computed tomography (CT) and magnetic resonance imaging (MRI)
performed to rule out any other conditions. The results of Mary’s CT and MRI showed
generalized and focal atrophy of the brain, specifically in the hippocampus. There
were several white matter lesions, which was likely amyloid plaques and
neurofibrillary tangles, associated with Alzheimer’s disease.
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The physician determined that Mary met the criteria for probable Alzheimer’s disease
and would be required complete supervision around the clock to insure her safety. The
physician prescribed donepezil (Aricept).
Photo: Alzheimer’s patients exhibit accelerated neurodegeneration, shown by open spaces (dark areas) in MRI images.
Butch, R. (n.d.). [Alzheimer’s Diases]. Retrieved July 8, 2018, from
https://www.hopkinsmedicine.org/research/advancements-in-research/fundamentals/in-depth/we-need-to-talk-about-alzheimers-dise
ase
Questions
1. Define the bold words.
2. Describe the cause of Alzheimer’s Disease.
3. Other neurological conditions must be ruled out when patients show signs of
dementia. Parkinson’s disease is another condition that can have memory impairment.
Compare the etiology, signs and symptoms, diagnosis and treatment for Parkinson’s
disease to Alzheimer’s.
4. Mary’s brother needs to be educated on the treatment for Alzheimer’s disease.
Explain the treatment using terms that Mary’s brother can understand. At minimum this
should include any at-home-care, over the counter medications, prescriptions,
alternative or complementary care. In addition, investigate any recent findings in
Alzheimer’s research within the last two years. It can be new finding/evidence on how it
is caused, diagnosed, prevented or treatment.
5. Explain the prognosis of the disease to Mary’s brother.
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Case Study – Multiple Sclerosis
Objectives
1. Explain the risk factors, symptoms, etiology, progression, diagnosis, treatment and
prognosis.
2. Demonstrate the ability to access and critically evaluate information from a wide
variety of sources (such as Library databases and internet sources).
Read the case presentation and answer the questions that follow. The Case Study
Rubric will be used to assess your work. The Case Study rubric lists the criteria for each
question (required resources, word counts and citation requirements).
Case Presentation
Rhonda is a 37-year-old female who
presents to the Neurology Clinic for
evaluation of her long-term neurologic
complaints. Rhonda states that for the
last two years she has had some
strange symptoms. She will have
periods of difficulty with walking, she has
had several near falls and has bouts of
blurry vision. She went through a
divorce a year and half ago, so she
attributed it to stress. Recently she had
the flu and her condition has worsened.
She is unable to hold objects in her
hands and is exhausted despite sleep. She has pain on the left side of her body,
continuous tinnitus and a sensation of spinning. Rhonda does not smoke or drink
alcoholic beverages and considers herself a healthy eater. She has been a vegan for at
least four years. A blood test to check Vitamin B12 levels was ordered and came back
within normal range. An MRI scan revealed multifocal white matter lesions. A
spinal tap revealed the presence of oligoclonal bands in the CSF. Visual evoked
response testing was abnormal with slowed conduction in optic nerves.
Photo: [Multiple Sclerosis]. (n.d.). Retrieved July 8, 2018, from
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Questions
1. Define the bold words.
2. Describe the cause of multiple sclerosis .
3. The physician ordered a blood test to check Rhonda’s Vitamin B12 levels.
Investigate why Rhonda may have been at risk for Vitamin B12 deficiency, signs and
symptoms that can occur with Vit B12 deficiency and how the deficiency is treated.
4. Rhonda needs to be educated on the treatment for multiple sclerosis. Explain the
treatment using terms that Rhonda can understand. At minimum this should include any
at- home-care, over the counter medications, prescriptions (includes physical therapy,
occupational therapy, counseling), alternative or complementary care.
5. Explain the prognosis of the disease to Rhonda and preventative measures, if any,
that can be taken to prevent her condition from worsening.