Essay Prompt
Compares and contrasts the pathophysiology between Alzheimer's disease and frontotemporal dementia. (CO1)\nIdentifies the clinical findings from the case that supports a diagnosis of Alzheimer's disease. (CO3)\nExplain one hypothesis that explains the development of Alzheimer's disease (CO3)\nDiscuss the patient's likely stage of Alzheimer's disease (CO4)\nCase Scenario\nA 76-year -old man is brought to the primary care office by his wife with concerns about his worsening memory. He is a retired lawyer who has recently been getting lost in the neighborhood where he has lived for 35 years. He was recently found wandering and has often been brought home by neighbors. When asked about this, he becomes angry and defensive and states that he was just trying to go to the store and get some bread.\nHis wife expressed concerns about his ability to make decisions as she came home two days ago to find that he allowed an unknown individual into the home to convince him to buy a home security system which they already have. He has also had trouble dressing himself and balancing his checkbook. At this point, she is considering hiring a day-time caregiver help him with dressing, meals and general supervision why she is at work.\nPast Medical History:\u00a0Gastroesophageal reflux (treated with diet); is negative for hypertension, hyperlipidemia, stroke or head injury or depression\nAllergies:\u00a0No known allergies\nMedications:\u00a0None\nFamily History\nFather deceased at age 78 of decline related to Alzheimer's disease\nMother deceased at age 80 of natural causes\nNo siblings\nSocial History\nDenies smoking\nDenies alcohol or recreational drug use\nRetired lawyer\nHobby: Golf at least twice a week\nReview of Systems\nConstitutional: Denies fatigue or insomnia\nHEENT: Denies nasal congestion, rhinorrhea or sore throat.\nChest: Denies dyspnea or coughing\nHeart: Denies chest pain, chest pressure or palpitations.\nLymph: Denies lymph node swelling.\nMusculoskeletal: denies falls or loss of balance; denies joint point or swelling\nGeneral Physical Exam\u202f\u202f\nConstitutional: Alert, angry but cooperative\nVital Signs: BP-128/72, T-98.6 F, P-76, RR-20\nWt. 178\u202flbs., Ht.\u202f6'0\", BMI 24.1\nHEENT\nHead normocephalic; Pupils equal and reactive to light bilaterally; EOM's intact\nNeck/Lymph Nodes\nNo abnormalities noted\nLungs\u202f\nBilateral breath sounds clear throughout lung fields.\nHeart\u202f\nS1 and S2 regular rate and rhythm, no rubs or murmurs.\nIntegumentary System\u202f\nWarm, dry and intact. Nail beds pink without clubbing.\nNeurological\nDeep tendon reflexes (DTRs): 2/2; muscle tone and strength 5/5; no gait abnormalities; sensation intact bilaterally; no aphasia\nDiagnostics\nMini-Mental State Examination (MMSE): Baseline score 12 out of 30 (moderate dementia)\nMRI: hippocampal atrophy\nBased on the clinical presentation and diagnostic findings, the patient is diagnosed with Alzheimer's type dementia.\nDiscussion Questions\nCompare and contrast the pathophysiology between Alzheimer's disease and frontotemporal dementia.\nIdentify the clinical findings from the case that supports a diagnosis of Alzheimer's disease.\nExplain one hypothesis that explains the development of Alzheimer's disease\nDiscuss the patient's likely stage of Alzheimer's disease.