the alzheimer’s disease
TRANSCRIPT
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The Alzheimers
DiseaseBy:
-Desti Omega R
-Devi Noviana
-Lona Maharani O
-Melanita Hardiyati
-Resti M
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Our
Topic
Case
Case Explaination
KeywordsClinical
Manifestation
Pathophysiology
Definitions Test and Diagnosis
Risk Factors
Outlook (Prognosis)
TreatmentEtiology
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The
Alzhei
mersDiseas
e
Case 32
An 83 years-old women is brought to the clinic by her husband
who was concerned with his wifes memory problems. He noticed
some memory decline a few years ago, but the onset was subtle and
did not interfere with her day-to-day activities. Mainly she has some
difficulty remembering details repeating things, and is being forgetful.
The patient family noticed her gradually increasing memory
problems, particulary over the past year. She is unable to remember
her appointment and relies heavily on writen notes and appointment
books. Resently she got lost while driving and was found by her
family 10 hours later. She was unable to use her cell phone and wasunsure about her home address and phone number. She has also
become more reclusive. She does not enjoy her church activities
anymore and prefers to stay at home most of the time. She does not
want to cook and she is less attentive to her housework. The patient
says that she has always been forgetful. Her medical history is
significant for well-controlled hypertention and a history of
mastectomy secondary to breast cancer diagnosed 20 years ago.
She has no significant story of tobacco or alcohol use. She is
independent with all activities of daily living, but needs assistance
with medication adminitration, banking, and transportation. She is up
to date with her health maintenance and immunization. Her vital
signs and general physical examination are normal.
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An 83 years-old women
Memory problem decline a few years ago
Difficult remembering details repeating things and
being forgetful
Unable to remember her appointment
She does not enjoy her church activities Her medical history is significant for well-controlled
hypertention
History of mastectomy secondary to breast cancer
No significant tobacco and alcohol use
She is up to date about her health maintenance andimmunization
Her vital sign and physical examination are normal
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Cas
eExpla
inatio
n
Component/
System
Complaint/Data Language Focus
Name
Age
SexOccuopation
Marital status
Present complaint
Onset
ENT
RS
CRV
GIS
GUS
CNS
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83 years-old
Female-
Marriage
Memory problem
A few years ago
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Whats your name?
How old are you?
Are you male or female?Whatsyour job?
Are you already have a family?
Whatsbought you along today?
How long have you had them?
Do you have any problem with your
ear, nose, or throat?
Do you have any problem with your
respiration? Like cough or
breathless?
Do you have any problem with your
heart? Like chest pain?
Do you have stomach pain after
eating something?
Any problem with your waterwork?
Do you feel discomfort when look at
the light?
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Cas
eExpla
inatio
n
Immediate
past history
Another data
Well-controlled
hypertention
Mastectomy secondary tobreast
Difficult remembering
details, repeating things
and being forgetful.
Recently she got lost while
driving.
Unable to use her cell
phone
Unsure about home
address and phone number
Not enjoy her chruch
activities and prefers to stay
at home.
No significant history of
tobacco or alcohol use
Do you have another sickness in
the past?
Do you have another sickness fornow?
Does something you want to tell
again?
Do you ever go somewhere and
get lost?
Can you use your cell phone?
Can you tell me where is your
home is?
Are you enjoy your activities on
chruch?
Are you a tobacco or alcohol
use?
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Definition
ofAlzh
eimers
Alzheimer's disease is a progressive, degenerative disorder that
attacks the brain's nerve cells, or neurons, resulting in loss of
memory, thinking and language skills, and behavioral changes.
Neurology in Clinical Practice.5thed. Philadelphia, Pa: Butterworth-
Heinemann Elsevier; 2008
A degenerative brain disease of unknown cause that is the most
common form of dementia, that usually starts in late middle age
or in old age, that results in progressive memory loss, impairedthinking, disorientation, and changes in personality and mood,
that leads in advanced cases to a profound decline in cognitive
and physical functioning, and that is marked histologically by the
degeneration of brain neurons especially in the cerebral cortex
and by the presence of neurofibrillary tangles and plaques
containing beta-amyloidabbreviationAD; called also
Alzheimer's
Alois(18641915),Germanneurologist
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Etio
logyofAlzheimers
The causes of Alzheimer's are not yet fullyunderstood
Older
Genetic(APOE
epsilon4allele)
Close blood
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Pathophys
iology
Genetic Abnormality
neurotransmittenImmunologyVirus attact
Decreasing metabolism and blood flow in cortex parietale
Atropy brain cells
Tangled neurofibrilloss of cholinergic fibers
in the cerebellum
Abnormality of
neurotransmitten
Decrease in acetylcholine
memory loss, intellectual impairment, behavioral, cognitive
Alzheimers Disease
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Clin
icalManifestations
ClinicalManifestationAlzheimers
MemorySpeaking and
writing
Disorientation andmisinterpreting
spatial relationships
Changes inpersonality and
behavior
Thinking andreasoning
Repeat statement
Depression,social withdrawl
aggresive
Difficultconcentrating and
thinking
What day is it?Seasons?
Have trouble to
identificate object
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Risk
Facto
rs
Risk Factors
Age LifestyleGenetic
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Testandd
iagnos
is
Test and Diagnosis
Physical andneurological exam
Mental statustesting
Lab tests
MRI dan CT-Scann
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Treatment
Drug
Cholinesterase inhibitors.These drugs work by boosting
levels of a cell-to-cell communication chemical depleted in
the brain by Alzheimer's disease. Most people can expect
To keep their current symptoms at bay for a time. Less thanhalf of those taking these drugs can expect to have any
improvement. Commonly prescribed cholinesterase
inhibitors include donepezil (Aricept), galantamine
(Razadyne) and rivastigmine (Exelon). The main side effects
of these drugs include diarrhea, nausea and sleep
disturbances.
Memantine (Namenda).This drug works in another brain
cell communication network and slows the progression of
symptoms with moderate to severe Alzheimer's disease. It's
sometimes used in combination with a cholinesterase
inhibitor.
Exercise
Nutritions
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How quickly AD gets worse is different for each
person. If AD develops quickly, it is more likely
to worsen quickly.
Patients with AD often die earlier than normal,although a patient may live anywhere from 3 - 20
years after diagnosis.
The final phase of the disease may last from a few
months to several years. During that time, the
patient becomes totally disabled. Death usuallyoccurs from an infection or organ failure.
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Con
clusio
n
Alzheimer's disease is a progressive,
degenerative disorder that attacks the brain's nerve
cells, or neurons, resulting in loss of memory,
thinking and language skills, and behavioral
changes.
In Alzheimer's disease, the connections
between brain cells and the brain cells themselves
degenerate and die, causing a steady decline in
memory and mental function.
Current Alzheimer's disease medications and
management strategies may temporarily improve
symptoms. This can sometimes help people with
Alzheimer's disease maximize function and
maintain independence. But because there's no
cure for Alzheimer's disease, it's important to seeksupportive services and tap into your support
network as early as possible.
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TH NKYOU