Question

Pathophysiology Case Study
Must use template. This case study is based on an individual person, not the disease as a whole.
Disease/Disorder Parkinson’s
Patient History Should include: Age, gender Signs/symptoms (S/S) and how long have they been present Any situation that exacerbates or lessens the S/S Social history – does the patient smoke, drink alcohol, or take drugs Family history – is there evidence that this condition is familial Medications the patient is taking
Diagnostic Tests Choose 2 tests from the 3 categories listed below: Specific lab tests (must include units and reference range). Explain how this test can be used to diagnose the condition. Imaging results (describe the procedure) Another procedure (besides lab or imaging) used to diagnose this condition (describe the procedure)
Pathophysiology Include: Describe the normal body function associated with this condition. How would the body function normally without this condition? Describe the pathology of this condition and how it adversely affects the normal functioning of the body
Treatments Give at least 2 specific examples of treatment options for this disease/condition. They can consist of specific drugs (must give dosage – give specific drug, not just class of drug), surgical procedure, radiation therapy, chemotherapy, biological therapy, etc. NOTE: must explain each treatment.
Interesting Fact Research a new piece of information not found in our textbook. It can be new research on this condition, a diagnostic test not explained in the book, a treatment not explained in the book, a personal experience with this condition, etc.

Answer 1

1. Patient history :-

- Age = 45 years

- Gender = Male

- Sign and symptoms = patient had shaking of hands while doing work (tremors) , slowed movements , difficulty in writing , postural instability , improper gait , speech changes like slurring of speech , writing changes micrgrapgia , mask like facial expression and rigidity and stiffness of upper and lower limbs . All these symptoms are present since 2 months .

- On taking rest the the symptoms lessons

- Social history = patient has a history of smoking .

- No family history of Parkinson's disease

- Medications = antihypertensive medications for hypertension

2.Diagnoatic test :-

a- Blood tests = No specific blood test is their to diagnose parkinsons disease , but we do blood test to find out whether any other condition is causing the symptoms Tests include CBC , LFT ,RFT

CBC :- Hb - normal range 14 to 16gm /dl

TLC - normal range 4000 to 11000 cells / cubic mm

Platelets = normal range 150000 to 450000 / microliter of blood

RBC's = normal range 4.7 to 6.1 million cells per microliter.

LFT AND RFT normal ranges :-

- Urea = 10 to 50 mg/dl

- Creatinine = 0.6 to 1.3 mg / dl

- Calcium = 8.5 to 10.2 mg /dl

- Phosphorus = 2.4 to 4.5 mg / dl

- Sodium = 135 to 145 mEq / l

- Potassium = 3.5 to 5.1 mEq / l

- Bilirubin = 0.1 to 1.2 mg / dl

- Uric acid = 2.4 to 6 mg / dl

- Total protein = 6 to 8gm / dl

- OT/ PT = up to 50

- ALP= 44 to 147 IU/l

b- Imaging = CT , MRI are done to see any changes in the brain parenchyma . In this procedure the patient is made to lie in a CT scan or MRI machine and is advised to stop breathing when the operator asks the patient to do so if the patient is conscious and multiple Coss sectional images of Brian is captured using X -ray and computer. In some of the imaging a radio opaque dye is used to take the images ,before that consent is taken from the patient and asked if he have any allergies to iodine , shell fish ,etc . CT and MRI scan are also not specific test to diagnose Parkinson's disease . Mostly diagnosis is made on the basis of the clinical manifestation , findings at the time of examination and the history .

3. Pathophysiology:-

Treatment of Parkinson's disease includes :-

Medications

Surgical

Supportive treatment

Medicines are levodopa ,the most effective medication that enters into brain and converts into dopamine .

Different categories of medicines are

Carbidopa - levodopa

Dopamine agonist

MAO B inhibitor

COMT ( catechol -O methyltransferase inhibitors

Anticholergenics

Amantadine

Surgical treatment - Deep brain stimulation in which doctors implant electrodes into specific parts of brain and is connected to generator placed in the chest that sends electric pulses to brain and reduces the Parkinson's symptoms.

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