Question

Pathophysiology Case Study
This case study is based on an individual person, not the disease as a whole.
Disease/Disorder: Parkinson’s Disease
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) Imaging results (describe how the abnormality differs from the normal functioning) Another procedure (besides lab or imaging) used to diagnose this condition (describe the procedure in your own words)
Pathophysiology Include: Describe the normal body function associated with 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), surgery, radiation therapy, chemotherapy, biological therapy, etc. NOTE: You must explain each treatment option separately in your own words.
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.
Reference If using information found on the Internet, copy the link from your source and paste it here. An article from a peer-reviewed medical journal is required to receive the maximum points.

Answer 1

1 Patient is a 45year ,white male . Presented with complaints of tremors and rigidity in upper and lower limbs along with decrease in speed of movement since one week. The symptoms exaggerated while doing the work. Patient has no family history of such conditions in the family and does not smoke or drink alcohol and no drugs other than antihypertensive agents for hypertension.

2. Diagnostic methods :-

- Basic blood investigation are done which includes CBC ,LFT RFT .

CBC Reference range :-

Hb -14-16gm /dl

Platelet -150000to 450000 per mcl of blood

RBC -4.7 to 6.1 million per mcl of blood

WBC - 4000 to 11000 per mcl of blood

LFT reference ranges:-

Total bilirubin - 0.1 to 1 mg/dl

Total protein - 6to 8 gm/dl

Albumin 3.5 to 5.5 gm/dl

SGOT/SGPT- upto 50

RFT reference ranges:-

Urea- 10 to 50 mg/dl

Creatinine - 0.6- 1.3 mg/dl

Sodium - 135 - 145mEq/l

Potassium -3.5- 5.1mEq/l

Calcium -8.1 to 10.2 mg/ dl

In imaging studies -SPECT( single photon emission computed tomography ) and positron emission tomography (PET) have been helpful in understanding the disease .

Patients history and presence of two or four cardinal manifestations tremor , rigidity ,bradykinesia and postural changes is the most reliable method to diagnose Parkinson disease.

3. Pathophysiology :-

4. Treatment options are :-

Pharmacological tharepy which includes :-

Levodopa -250 to 500mg twice a day , most effective agent and the main treatment.

Anticholinergic agents to control tremor and rigidity.

Example benztropin (1-2mg/day) ,trihexiphenidyl

Amantadine hydrochloride an antiviral agent to reduce tremor , rigidity,and bradykinesia.(200mg in 1-2divided doses)

Dopamine agonists like pergolide(initial 0.05mg once a day) , bromocriptine

Monoamine oxidase inhibitors to inhibit dopamine breakdown. Example selegiline (10mg/day).

Catechol-O- methyltransferase inhibitors to reduce motor fluctuations .

Antidepressants

Antihistamines

2. Surgical management includes :-

surgeryto destroy a part of thalamus to interrupt nerve pathway and allievate tremor and rigidity .

Transplantation of metal cells from fetal tissue of human or animal source to re-establish normal dopamine release.

Deep brain stimulation with pacemaker like brain implant to block nerve pathway that cause tremor.