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NR 601 Week 1 Case Study Discussions Physical Examination (Part 1) NEW

Discussion Part One (graded)

 You meet your first patient of the morning. A.K. is a 65-year-old Caucasian male who you are seeing for the first time. Both wife and daughter are present.

Background

He reports that he has had an 18-pound unintentional weight loss in the last 2 months “I am just not hungry anymore, and when I do eat, I get full so fast. In fact, it is really hard to eat, and I don’t eat nearly as much as usual, even though I eat 3 times every day”. He also reports feeling more tired than usual. “I am not sleeping very well. My wife wakes me up when I am snoring, or when she thinks I am not breathing. I used to have sleep apnea, but I don’t think I have it anymore. Besides, that mask is so horrible to wear.” He reports day time somnolence. He reports that he is at the clinic today because of his wife and daughter’s concern about his weight loss and loss of appetite.

PMH

Mr. A.K. has a history of hypertension, cataracts, and osteoarthritis. Current medications:

Ibuprofen 600 mg po TID

Lisinopril 20 mg po QD

Hydrochlorothiazide 25 mg PO QD

Simvastatin 20 mg po QD

Vitamin D3 50,000 units po weekly

Omeprazole 40 mg po QD

Sudafed 50 mg po TID prn

Surgeries      

 April 2010-Right cataract extraction with Intraocular Lens Placement  June 2010- Left cataract extraction with Intraocular Lens Placement  November 2011-Left total knee arthroplasty

Allergies: No known drug or food allergies. Allergies to latex causing difficulty breathing and to bee stings, causing widespread edema and airway obstruction.

Vaccination History

He receives annual flu shots “most of the time”. His last one was 18 months ago.

Received a Pneumovax “the day I turned 65”.

His last TD was greater than 10 years ago.

Has not had the herpes zoster vaccine.

Social history

He has an 8th grade education and is a retired concrete finisher. He lives with his wife of 45 years and his daughter lives next door. He enjoys working in his back yard garden and recently tripped over the garden hose last week where his neighbor had to come and help him up.

Family history

Both parents are deceased. Father died of a heart attack at the age of 80; mother died of breast cancer at the age of 76. He has one daughter who is 45 years old and has hypertension. Hypertension, coronary artery disease, and cancer runs in the family.

Habits

He drinks one 4 ounce glass of red wine nightly; previous smoker of 30 years; he quit for 10 years, and is now smoking ¼ pack per day for the last 6 months.

  Discussion Part One:

Provide the differential diagnoses (DD) with rationale

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PSY 330 Week 2 DQ 1 Neurobiology

Select one of the following options for this discussion.  Indicate in your post which option you are responding to. Option A:  Review this week’s reading, which introduced the role of neurotransmitters in human behavior and personality.  Use the Ashford University Online Library to locate one peer-reviewed research study which was published in the last five years and that implicates a neurotransmitter as the cause of an abnormal behavior (psychological disorder).  Clearly indicate in your discussion:

a.   The abnormal behavior being studied. b.   The neurotransmitter that is implicated. c.   The role of the neurotransmitter in the expression of the abnormal behavior.  

Your initial post should be a minimum of 250 words and utilize at least one peer-reviewed source that was published within the last five years, cited according to APA guidelines as outlined in the Ashford Writing Center. Guided Response: Review several of your classmates’ posts.  Respond substantively to two peers who chose a different neurotransmitter or abnormal behavior than you did.  Address the role of the neurotransmitter in the expression of the abnormal behavior that they each selected.  Are there other possible explanations for the cause of this abnormal behavior?  Which explanation do you think makes the most sense?  Why?    Option B: Review this week’s reading, which introduced the impact of early trauma on function and personality development.  Use the Ashford University Online Library to locate a peer-reviewed research study which was published within the last five years and that examines the impact of brain trauma on the function and development of personality.  Clearly indicate in your discussion:

a.   The trauma that occurred. b.   The duration between the time of the trauma and the research study. c.   The impact of the trauma on overall function. d.   The impact of the trauma on personality and behavior.

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