BSC 2346 AP 1 Module 6 Case Study.

• Question 1 Module 6 Case Study AP1 1 out of 1 points Donna, a 42-year-old mother of two, has been experiencing intermittent tingling and numbness in both of her feet. She has also had trouble holding a pen while writing. In the past few months, the tingling and numbness in her extremities seemed to subside on its own, so she was not very concerned. Recently, though, the symptoms have spread to her knees and thighs and are persisting. Yesterday, she stumbled when getting out of bed in the morning. When she tried to stand, her right leg was too weak to hold her weight and she fell again. She noticed that she scraped her right knee during the fall, but does not feel any pain from the wound. Donna notices that she has blurry vision and thinks that might be the reason she fell. All of the following indicate sensory deficits EXCEPT: Selected Answer: Muscular weakness • Question 2 Donna does not feel the wound on her knee. In a normal situation, describe how this sensory input of a scraped knee would result in the feeling of pain. Needs Grading Selected Answer: When you scrape your knee the site has damage to the tissues which is registered by nociceptors, or pain receptors. These pain receptors are the ending points of a neuron and send an electrical signal up the axon or nerve fiber to a bundle of other nerve fibers that creates a peripheral nerve. The electrical signal travels up neurons in the peripheral nerve towards the neck and reaches the spinal cord. At this point the electrical signal travels to another neuron through a small gap called a synapse. This is able to be done through neurotransmitters. The electrical signal then travels up the nerve fiber of the spinal cord and relays the sensory input information to the brain and allows us to feel and react to the pain. MyDr. (n.d.). Pain and how you send it. Retrieved May 10, 2018, from Respons e Feedbac k: [None Given] • Question 3 Donna has weakness in her right leg, but her left leg is functioning normally. Which components of the nervous system are involved with skeletal muscle Needs Grading movement? Be specific about how the motor impulse moves through the body. Selected Answer: The somatic nervous system is responsible for muscle movement. A motor impulse is sent through the body by sending the signals from neuron to neuron via th synapse and traveling along motor fibers. This signal then reaches the muscle and an action response is carried out. Biology dictionary. (n.d.). Somatic nervous system. Retrieved May 10, 2018, from Respons e Feedbac k: [None Given] • Question 4 Which of the following correctly defines a motor unit? 1 out of 1 points Selected Answer: A single neuron and all the muscle cells it innervates • Question 5 Which of the following statements is true? 1 out of 1 points Selected Answer: Donna is experiencing both motor and sensory deficits. • Question 6 List and describe any and all symptoms in Donna’s history that could be related to a pathology of her motor neurons. Needs Grading Selected Answer: Holding a pen while writing, muscle weakness in lower extremities. Henderson, J. M. (n.d.). Motor impairment. Retrieved May 10, 2018, from Response Feedback: [None Given] • Question 7 1 out of 1 points Donna’s primary care physician wants to screen her for Multiple Sclerosis. Which of the following tests would provide the most definitive diagnosis for MS? Selected Answer: MRI • Question 8 If Donna does have MS, the disease is affecting her myelin sheath. Briefly describe what happens to the myelin sheath and how it disrupts nerve function in patients with Multiple Sclerosis. Needs Grading Sele In MS the T-cells from the body's immune system attack the myelin sheath which cted causes damage, or full destruction of the sheath. Because of this damage, or Ans wer: destruction, the axon is left uninsulated and exposed. When messages are being sent from the brain to the various body parts, they are delayed, and possibly distorted, causing misinterpretation of the wanted reaction. Dangond, F. (n.d.). Myelin sheath in multiple sclerosis. Retrieved May 10, 2018, from Res pon se Fee dba ck: [None Given] • Question 9 Donna later sees a specialist who wants to perform a spinal tap, which is an analysis of cerebrospinal fluid. Where is cerebrospinal fluid (CSF) found? 1 out of 1 points Selected Answer: Surrounding the structures of the Central Nervous System • Question 10 After extensive testing, Donna’s care team concluded that she does have Multiple Sclerosis and have prescribed steroid treatment. How will steroids help alleviate her symptoms? Needs Grading Selected Answer: Steroids are used as an anti inflammatory. They suppress the multiple pathways that are inflamed in the body. In MS there are exacerbations, or flare ups, of inflammation to the nerve pathways. Steroids are used to control the inflammation and aid in stopping any acute damage for occuring. Minton, L. S. (n.d.). Corticosteroids for the treatment of MS. Retrieved May 10, 2018, from Respons e Feedbac k: [None Given] • Question 11 Andre is a 68-year-old grandfather who has been struggling with his memory lately. At 1 out of 1 points first, he was simply forgetting an appointment from time to time or forgetting to take his morning vitamins. However, now his spouse and children have noticed that his forgetfulness is progressing. There have been moments where he forgot how to get home, couldn’t remember his own phone number, or the names of his grandchildren. His family is worried he may have Alzheimer’s disease and they are not sure what to do. Andre’s family decides to do some research about dementia and Alzheimer’s disease. Which of the following statements is true? Selected Answer: Alzheimer’s disease is a form of dementia. • Question 12 Which of the following is NOT a typical symptom of Alzheimer’s disease? 1 out of 1 points Selected Answer: Forgetting appointments, but remembering them later • Question 13 Which of the following scenarios is considered a normal age-related change in memory? 1 out of 1 points Selected Answer: Misplacing items occasionally and needing to retrace steps to find them • Question 14 What are the risk factors in Andre’s history that would support a diagnosis of Alzheimer’s disease? Needs Grading Selected Answer: Risk factor in Andre's history is age. After the age of 65 your chances of being developing Alzheimer's is doubled every 5 years. Alzheimers Society of Canada. (n.d.). Risk factors of Alzheimers. Retrieved May 10, 2018, from Response Feedback: [None Given] • Question 15 What other Alzheimer’s disease risk factors might exist that are not given in Andre’s history? List and describe at least 5 risk factors. Needs Grading Selected Answer: Some other Alzheimer's disease risk factors are: Smoking - Study shows smokers are more likely to develop Alzheimer's than nonsmokers. Obesity - Obesity can double chances of developing Alzheimer's, especially if you have a BMI over 30. Poor diet - Those who don't eat enough fruits or vegetables are at a higher risk. Head trauma - Serious head injuries, or repeated injuries with loss of consciousness, like in contact sports, lead to an increased risk. Family history - If you have a parent, sibling, or child with Alzheimer's you are at a higher risk than those with no family history. You are even more at risk if you have multiple family members. Legg, T. J. (2016, September 23). Alzheimer's disease risk factors. Retrieved May 10, 2018, from Response [None Given] Feedback : • Question 16 As Alzheimer’s disease progresses, the brain produces less and less of which neurotransmitter? 1 out of 1 points Selected Answer: Acetylcholi ne • Question 17 Alzheimer’s disease is diagnosed using all of the following tools EXCEPT: 1 out of 1 points Selected Answer: Peripheral nerve biopsy • Question 18 Describe how the plaques found in Alzheimer’s disease disrupt nerve impulses. Needs Grading B Selecte Amyloid plaques, also known as protein fragments, are normally produced d Answer: by the body. However they are also normally broken down and eliminated, but in Alzheimer's they do not. Instead they form a hard, insoluble plaque that attach between the neurons in the break, causing a block in the nerve impulses from traveling between neurons. Bright Focus. (2015, July 2). The progression of Alzheimer's disease. Retrieved May 10, 2018, from Respons [None Given] e Feedbac k: • Question 19 There is no cure for Alzheimer’s disease, but cholinesterase inhibitors can be Needs Grading used to treat symptoms like memory loss or language issues. Briefly discuss how this type of medication affects the physiology of neurons and nerve impulses. Selected Answer: Cholinesterase inhibitors primary effect is to block the breakdown of the neurotransmitter acetylcholine at the synapse between neurons. There is more breakdown of this neurotransmitter, than there is production of it, and this medication is an attempt to compensate for that. This causes a delay in the cognitive decline of those with Alzheimer's. Lakhan, S. E. (n.d.). Alzheimer disease treatment and management. Retrieved May 10, 2018, from Respons e Feedbac k: [None Given] • Question 20 Andre’s primary care physician will likely refer him to a specialist. Which type of specialist treats Alzheimer’s disease? With the information you are given about Andre, how do you think his specialist will proceed? List and describe at least 3 treatments, tests, or other options that would make sense for Andre’s stage of memory loss. Needs Grading Selected Answer: A specialist that Andre will likely be referred to is a neurologist. This specialist may proceed with blood work or MRI scans to affirmatively diagnose Alzheimer's disease, or to see the progression of it. From his symptoms, it appears that Andre is in stage 3 of Alzheimer's disease. Three treatment options that would make sens for his stage of memory loss are Medications such as Donepezil, or Rivestagmine, which are Cholinesterase inhibitors, to help slow down cognitive loss, increasing exercise and routine social engagements, which help keep the mind sharp. Finally keeping routines, such as placing keys, phone, wallet, and other valuables in the same place in the home setting, keeping photographs and meaningful items around the house, and keeping future appointments all on the same day and time if possible. A sense of routine will help keep familiarity with Andre. As a safety measure, a GPS tracking device should be placed on the phone as well, since he is forgetting how to get home. Alzheimer's Association. (n.d.). Seven stages of Alzheimer's. Retrieved May 10, 2018, from Mayo Clinic. (2017, December 30). Alzheimer's disease - diagnosis and treatment. Retrieved May 10, 2018, from Respons e Feedbac k: [None Given]