1. Compare and contrast the pathophysiology between Alzheimer's disease and frontotemporal dementia.
  2. Identify the clinical findings from the case that supports a diagnosis of Alzheimer's disease.  
  3. Explain one hypothesis that explains the development of Alzheimer's disease
  4. Discuss the patient's likely stage of Alzheimer's disease.

Preparing the Assignment

Requirements

1. Read the case study below.

2. In your initial discussion post, answer the questions related to the case scenario and support your response with at least one evidence-based reference by Wed., 11:59 pm MT.

3. Provides a minimum of two responses weekly on separate days; e.g., replies to a post from a peer; AND faculty member’s question; OR two peers if no faculty question using appropriate resources, before Sun., 11:59 pm MT.

Case Scenario

A 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.

His 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.

Past Medical History: Gastroesophageal reflux (treated with diet); is negative for hypertension, hyperlipidemia, stroke or head injury or depression

Allergies: No known allergies

Medications: None

Family History

· Father deceased at age 78 of decline related to Alzheimer's disease

· Mother deceased at age 80 of natural causes 

· No siblings

Social History

· Denies smoking

· Denies alcohol or recreational drug use 

· Retired lawyer

· Hobby: Golf at least twice a week

Review of Systems

· Constitutional: Denies fatigue or insomnia

· HEENT: Denies nasal congestion, rhinorrhea or sore throat.  

· Chest: Denies dyspnea or coughing

· Heart: Denies chest pain, chest pressure or palpitations.

· Lymph: Denies lymph node swelling.

· Musculoskeletal: denies falls or loss of balance; denies joint point or swelling

General Physical Exam  

· Constitutional: Alert, angry but cooperative

· Vital Signs: BP-128/72, T-98.6 F, P-76, RR-20

· Wt. 178 lbs., Ht. 6'0", BMI 24.1

HEENT

· Head normocephalic; Pupils equal and reactive to light bilaterally; EOM's intact

Neck/Lymph Nodes

· No abnormalities noted  

Lungs 

· Bilateral breath sounds clear throughout lung fields.

Heart 

· S1 and S2 regular rate and rhythm, no rubs or murmurs. 

Integumentary System 

· Warm, dry and intact. Nail beds pink without clubbing.  

Neurological

· Deep tendon reflexes (DTRs): 2/2; muscle tone and strength 5/5; no gait abnormalities; sensation intact bilaterally; no aphasia

Diagnostics

· Mini-Mental State Examination (MMSE): Baseline score 12 out of 30 (moderate dementia)

· MRI: hippocampal atrophy

· Based on the clinical presentation and diagnostic findings, the patient is diagnosed with Alzheimer's type dementia.

Discussion Questions

1. Compare and contrast the pathophysiology between Alzheimer's disease and frontotemporal dementia.

2. Identify the clinical findings from the case that supports a diagnosis of Alzheimer's disease.  

3. Explain one hypothesis that explains the development of Alzheimer's disease

4. Discuss the patient's likely stage of Alzheimer's disease.

NR507 Week 7 Discussion Rubric

NR507 Week 7 Discussion Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeApplication of Course Knowledge:

The student:  1. Compares and contrasts the pathophysiology between Alzheimer’s disease and frontotemporal dementia.  2. Identifies the clinical findings from the case that supports a diagnosis of Alzheimer’s disease.  3. Explains one hypothesis that explains the development of Alzheimer’s disease.  4. Discusses the patient’s likely stage of Alzheimer’s disease (4 critical elements)

30 pts

All critical elements are met.

27 pts

1 critical element is missing.

25 pts

2 critical elements are missing.

15 pts

3 critical elements are missing.

0 pts

All 4 critical elements are missing.

30 pts

This criterion is linked to a Learning OutcomeSupport from Evidence-Based Practice:

Initial discussion post is supported with appropriate, scholarly sources;  AND  Sources are published within the last 5 years (unless it is the most current CPG);  AND  Reference list is provided and in-text citations match; AND  All answers are fully supported with an appropriate EBM argument.

30 pts

All critical elements are met.

27 pts

1 critical element is missing.

25 pts

2 critical elements are missing.

15 pts

3 critical elements are missing.

0 pts

All 4 critical elements are missing.

30 pts

This criterion is linked to a Learning OutcomeInteractive Dialogue:

In addition to providing a response to the initial post due by Wednesday, 11:59 p.m. MT, student provides a minimum of two responses weekly on separate days; e.g., replies to a post from a peer; AND faculty member’s question; OR two peers if no faculty question. A response to faculty could include a question posed to a student or the entire class or a faculty question directed towards another student. AND  • Evidence from appropriate scholarly sources are included; AND • Reference list is provided and in-text citations match

30 pts

All critical elements are met.

27 pts

1 critical element is missing.

25 pts

2 critical elements are missing.

15 pts

3 critical elements are missing.

0 pts

All 4 critical elements are missing.

30 pts

This criterion is linked to a Learning OutcomeOrganization:

Case study responses are presented in a logical format; AND  Responses are in sequence with the numbered questions; AND  The case study response is understandable and easy to follow;  AND  All responses are relevant to the case topic.

5 pts

All critical elements are met.

4 pts

1 critical element is missing.

3 pts

2 critical elements are missing.

2 pts

3 critical elements are missing.

0 pts

All 4 critical elements are missing.

5 pts

This criterion is linked to a Learning OutcomeGrammar, Syntax and Spelling

Discussion post has minimal grammar, syntax, spelling, punctuation, or APA format errors*  (*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.

5 pts

0-1 errors in grammar, syntax, spelling, punctuation, or APA format*

4 pts

2-3 errors in grammar, syntax, spelling, punctuation, or APA format*

3 pts

4-5 errors in grammar, syntax, spelling, punctuation, or APA format*

2 pts

6-9 errors in grammar, syntax, spelling, punctuation, or APA format*

0 pts

10 or more error in grammar, syntax, spelling, punctuation, or APA format*

5 pts

This criterion is linked to a Learning OutcomeParticipation

0 pts

Discussion late penalty deductions

A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0)

0 pts

Total Participation Responses:

A 10% penalty will be imposed for not entering the minimum number/type of interactive dialogue posts OR not posting on the minimum required number of days: 3. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0)

0 pts

Total Points: 100