Neurological System Case Study – #1Mrs. Smith is an 85 year female with a history of Hypertension,diabetes and osteoarthritis. Her daughter who cares for her reports thatshe became suddenly confused beginning last night. She recognizes herdaughter but has been unable to remember her grandchildren’s names. Shecontinuously asks her daughter “What are those kids doing in our house?”Her mother was in and out of bed all night and slept very little. Herdaughter does say that her mother seemed better this morning, but on theway to your office she became more confused again. Review of systems issignificant for a dry cough for the past few days. She has not had afever. Her appetite has been poor. Her exam is normal except for somefine crackles in her left lung base. Mrs. Smith’s daughter says, ‘My dadhad Alzheimer’s and now it looks like I am going to have to go throughthat with my mother”1) What are the possibilities for change in Mrs. Smith’s current mental status?2) What is your top differential diagnosis? Give 3 reasons why you chose that diagnosis.3) How can you differentiate depression, dementia and delirium?4) Explain to Mrs. Smith’s daughter what treatment is needed and what you think her prognosis is.Neurological System Case Study – #2A 40-year-old male comes to see you for follow up. He states that hehad a seizure at home yesterday and was taken to the emergency room. Heis accompanied by his wife who witnessed the seizure. He states he hasnever had a seizure in the past.Discussion Questions:1) What would you ask him and his wife regarding the seizures, and why? 2) What would be the most important parts of a physical exam in this patient and why?3) What lab or radiology tests would you want to do and why? He tellsyou he has no insurance so be sure to defend the importance of aparticular test.
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