Presentation must include a Slides with the following information.
· TITLE (slide 1)
· DESCRIPTION (Patient information) (slide 2 etc.. and so on)
· EPIDEMIOLOGY
· ETIOLOGY
· RISK FACTORS
· ASSOCIATED CONDITIONS
· HISTORY
· PHYSICAL EXAM
· DIFFERENTIAL DIAGNOSIS
· TESTS
· TREATMENT
· PROGNOSIS
· REFERENCES
Turn it in include it.
Parkinson’s disease Final presentation: Laboratory for Diagnosis, Symptom and \ Illness Management.
1
Yisel Castro
Lianne Blanco
Patient information
Name: Luis Morel
Age: 62 years
Gender: Male
RACE: HISPANIC
MARITAL Status: Married
Medication Intolerance: Denied
Allergies: Seafood.
Chronic Illnesses/Major traumas: Controlled Hypertension
Hospitalizations/Surgeries: Inguinal Hernia (2 years ago).
Immunization: Updated (PCV13, Influenza, RZV,).
Hospitalizations/Surgeries: Denied
2
Epidemiology of Parkinson Disease
First symptoms appear usually after age of 40 years but have been reported cases in children’s and is called Juvenile Parkinsonism.
Aged 50 years and over are affected in 1 %, this number increased in 10 % in person 60 years and over about 1½ times more common in men than in women.
The causes of Parkinson’s disease (PD), the second most common neurodegenerative disorder, are still largely unknown. Current thinking is that major gene mutations cause only a small proportion of all cases and that in most cases, non-genetic factors play a part, probably in interaction with susceptibility genes. Numerous epidemiological studies have been done to identify such non-genetic risk factors, but most were small and methodologically limited. Larger, well-designed prospective cohort studies have only recently reached a stage at which they have enough incident patients and person-years of follow-up to investigate possible risk factors and their interactions.
3
Etiology
Primary (idiopathic- most common):
unknown origin but not induced by obvious stimulus.
Secondary (parkinsonism): related to drugs, stroke, or trauma, other stimuli
Familial: Genetics related, are included 20 % of the existing cases diagnosed
4
Risk Factors Heredity.
Age. (60 or older)
Sex.
Autoimmune factors
Exposure to toxins
5
Thinking difficulties
Depression and emotional changes
Swallowing problems
Chewing and eating problems
Sleep problems and sleep disorders
Bladder problems
Constipation
Blood pressure changes
Smell dysfunction
Sexual dysfunction
fatigue
Associated conditions
6
PATIENT history
Patient is 62 years old, male, Hispanic descendent, recently discharged from US Army after 25 years of service. He is today looking for medical advice after has been notice a little resting tremor in both hands more marked in right hand, also noted slow motion in some movement mainly with changes of position and some incoordination when he walks. He is concerned because his paternal Grandfather died after suffering for many years with Parkinson’ s disease related disabilities, his father died at 43 years old in a motor vehicle accident and no time to development the disease and he hears that Parkinson’s Disease has some genetics implication. His medical history is only remarkable for a 10 years history of well controlled High Blood Pressure and not remarkable Family History except for what we mention before. He is happily married for 25 years and has 2 healthy sons studying in college for whom he is worried too in case that this has some degree of genetics transmition.
7
Physical Examination
Weight: 187 p0unds
Height 5’11”
BMI: 26.1
Temp: 97.9 f
PULSE: 76
RESPIRATION: 18
BP: 125/ 75 MMHG
Physical Exam:
General Appearance: Healthy appearing adult male in no acute distress. Alert and oriented; answers questions appropriately.
Skin: Skin is normal color for ethnicity, warm, oily, clean and intact. No rashes or lesions noted.
HEENT: Head is norm cephalic, hair with frontal alopecia. Neck: Supple. Full ROM. Teeth are in good repair.
Cardiovascular: S1, S2 with regular rate and rhythm. No extra heart sounds.
Respiratory: Symmetric chest walls. Respirations regular and easy; lungs clear to auscultation bilaterally.
Gastrointestinal: Abdomen round; BS active in all 4 quadrants. Abdomen soft, no tender. No hepatosplenomegaly.
Genitourinary: Skin normal for ethnicity. Penis and testis with no apparent lesions, no discharge. No adenopathy .
Musculoskeletal: Resting tremors. Rigidity seen in all 4 extremities as patient moved about the exam room.
Neurological :Speech clear. Good tone. Postural instability ; gait abnormal with uncoordinated arms balance.
Psychiatric: Alert and oriented. Dressed in clean clothes. Maintains eye contact. Answers questions appropriately.
9
Differential Diagnosis :
Neurologic Disorder:
Spinocerebellar ataxia
Huntington’s disease
Essential tremor
NON-NEUROLOGIC DISORDERS:
Arthritis
Depression
Obsessional slowness
10
Test:
No specific test exists to diagnose Parkinson’s disease. We can diagnose Parkinson’s disease based on your medical history, a review of signs and symptoms, and a neurological and physical examination. may suggest a specific single-photon emission computerized tomography SPECT scan called a dopamine transporter (DAT) scan. Although this can help support the suspicion that you have Parkinson’s disease, it the symptoms and neurologic examination that ultimately determine the correct diagnosis. Most people do not require a DAT scan. We can order too blood tests, to rule out other conditions that may be causing the symptoms.
Imaging tests — such as MRI, CT, ultrasound of the brain, and PET scans — may also be used to help rule out other disorders. Imaging tests aren’t particularly helpful for diagnosing Parkinson’s disease.
In addition to the examination, we can prescribe carbidopa-levodopa (Rytary, Sinemet, others), a Parkinson’s disease medication, and must be given a sufficient dose to show the benefit, as low doses for a day or two aren’t reliable. Significant improvement with this medication will often confirm your diagnosis of Parkinson’s disease.
Sometimes it takes time to diagnose Parkinson’s disease. we may recommend regular follow-up appointments with neurologists trained in movement disorders to evaluate your condition and symptoms over time and diagnose Parkinson’s disease.
Treatment
Lifestyle modification:
Healthy eating
Exercise
Avoiding falls
Daily living activities
Medications:
Carbidopa-levodopa
MAO inhibitors ((Eldepryl, Zelapar), rasagiline (Azilect) and safinamide (Xadago)
Catechol O-methyltransferase (COMT) inhibitors (Entacapone)
Anticholinergics. (benztropine (Cogentin) or trihexyphenidyl.)
Surgical procedures
Deep brain stimulation
12
Prognosis:
Risk of Dementia
Mortality Risk
Especially patients with Parkinson disease who carry an APOE ε2 allele have an increased risk of developing dementia. Increased mortality risk in Parkinson disease is dependent on disease duration and is only modest in the absence of dementia.
The prevalence of Parkinson disease (PD), the second most common neurodegenerative disorder, is expected to increase as populations worldwide age. Insight into the prognosis is therefore desirable. Parkinson disease has been associated with an increased risk of developing dementia and a reduced life expectancy.
references
Giesbergen, PC,. MCHofman, AKoudstaal PJBreteler. MM Incidence of parkinsonism and Parkinson disease in a general population: the Rotterdam Study. Neurology. 2015;631240- 1244
Ruitenberg, A., Avan, S.,Hofman, ABreteler, M. Incidence of dementia: does gender make a difference? NeurobiolAging 2011;22, 575- 580.
Nakazato Y, Sasaki A, Hirato J, Ishida Y. Immunohistochemical localization of neurofilament protein in neuronal degenerations. Acta Neuropathol 2012; 64:30-6.
What Students Are Saying About Us
.......... Customer ID: 12*** | Rating: ⭐⭐⭐⭐⭐"Honestly, I was afraid to send my paper to you, but splendidwritings.com proved they are a trustworthy service. My essay was done in less than a day, and I received a brilliant piece. I didn’t even believe it was my essay at first 🙂 Great job, thank you!"
.......... Customer ID: 14***| Rating: ⭐⭐⭐⭐⭐
"The company has some nice prices and good content. I ordered a term paper here and got a very good one. I'll keep ordering from this website."
