nr507 week 7 discussions
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Week 7: Behavioral, Neurologic, and Digestive Disorders –
Discussion Part
One
This week’s graded topics relate to the following Course Outcomes
(COs).
1 Analyze pathophysiologic mechanisms associated with selected
disease states. (PO 1)
2 Differentiate the epidemiology, etiology, developmental
considerations, pathogenesis, and clinical and laboratory manifestations of
specific disease processes. (PO 1)
3 Examine the way in which homeostatic, adaptive, and compensatory
physiological mechanisms can be supported and/or altered through specific
therapeutic interventions. (PO 1, 7)
4 Distinguish risk factors associated with selected disease
states. (PO 1)
5 Describe outcomes of disruptive or alterations in specific
physiologic processes. (PO 1)
6 Distinguish risk factors associated with selected disease
states. (PO 1)
7 Explore age-specific and developmental alterations in
physiologic and disease states. (PO 1, 4)
You are at the local mall and you see a patient who appears to be
homeless by his physical appearance and you witness the person “walk 50 feet to
a table sit down, and after 5 seconds he gets up and walks to a tree and
urinates on it” He repeats this action 5 times apparently oblivious to his
surroundings. When the police come he ignores them as if they aren’t there.
Later, you go to work and sitting in examROOM
3
is
the same person! Now, he is your patient, when you talk to him he has no
recollection of his behavior by the mall.
is
the same person! Now, he is your patient, when you talk to him he has no
recollection of his behavior by the mall.
§ What is your
differential diagnosis?
§ What tests do you order?
§ An MRI comes back and
there seems to be a lesion in the temporal lobe does this change your
differential? The EEG also comes back with unusual excitatory activity. What is
your definitive diagnosis? In retrospect did anything bias your first
differential?
Week 7: Behavioral, Neurologic, and Digestive Disorders –
Discussion
Part Two
Your patient is a 77-year-old woman who has been more socially
withdrawn lately and told her daughter she had not been feeling well. Her
daughter has noticed a stepwise decline. While shopping for groceries with her
daughter she became separated from daughter in the aisles. She became confused
and angry when store employees and others tried to assist her. Her current
medications are Hydrochlorothiazide, Lisinopril and Atorvastatin.
§ What is your differential
diagnosis based on the information you now have?
§ What other questions
would you like to ask her now? (Questions can be asked of patient first, and
then of reliable historian separately.)
§ How would you treat this
patient and discuss why you give each medication or therapy you give.
Week 7: Behavioral, Neurologic, and Digestive Disorders –
Discussion Part Three
1 Analyze pathophysiologic mechanisms associated with selected
disease states. (PO 1)
2 Differentiate the epidemiology, etiology, developmental
considerations, pathogenesis, and clinical and laboratory manifestations of
specific disease processes. (PO 1)
3 Examine the way in which homeostatic, adaptive, and compensatory
physiological mechanisms can be supported and/or altered through specific
therapeutic interventions. (PO 1, 7)
4 Distinguish risk factors associated with selected disease
states. (PO 1)
5 Describe outcomes of disruptive or alterations in specific
physiologic processes. (PO 1)
6 Distinguish risk factors associated with selected disease
states. (PO 1)
7 Explore age-specific and developmental alterations in
physiologic and disease states. (PO 1, 4)
A 19-year-old freshman in college has been brought to your office
by campus security. The patient had been standing on top of the school chapel
proclaiming that he was the prophet of God and that God was speaking to him. In
fact he claimed to actually hear God’s voice. When he is in your office you
notice that he is speaking very fast, can’t seem to sit still and his sentences
at times don’t seem to make sense. He states, “I saw the professor sit on the
ham sandwich and eat the raw calculus in his mind”
§ What is your
differential diagnosis, how does it fit how might it not fit?
§ Based on the top of your
differential what is the epidemiology of that disorder?
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