MA278/BSC2346 Module 7 Case Study

QUESTION 1

Scott, a 37-year-old elementary teacher, is seeing his general practitioner for complaints of general weakness, especially in his lower extremities. He has also been feeling very fatigued lately and has trouble keeping up with his students throughout his work day. His physician notes that he has lost a significant amount of weight in the last 6 months. Scott reports that even simple tasks, such as brushing his hair and getting dressed, can seem like a chore. He has trouble climbing stairs because of his weakness and notices that his speech is slurred, especially at the end of the day.

 

Scott’s physician uses a tongue depressor during his physical examination and Scott begins to gag and has difficulty swallowing. His physician notes muscle wasting and abnormal spasticity in upper and lower extremities bilaterally. All reflexes are normal except the Babinski reflex. Scott’s toes fan out when the sole of his feet are stroked with the reflex hammer.

 

Scott’s symptoms are primarily related to problems with:

Both sensory and motor neurons

Motor neurons

Neurons of the autonomic nervous system only

Sensory neurons

1 points

 

QUESTION 2

 

Because Scott’s symptoms are progressively getting worse over a period of several months, we can rule out which of the following diagnoses?

 

 

Muscular dystrophy

 

 

Multiple Sclerosis

 

 

Amyotrophic Lateral Sclerosis

 

 

Traumatic spinal cord hemisection

 

1 points

 

QUESTION 3

 

Scott’s physician believes he may have ALS. Briefly describe this condition in your own words.

 

 

 

 

Path: pWords:0

1 points

 

QUESTION 4

 

Which of the following is NOT an early symptom of ALS?

 

 

Fatigue

 

 

Difficulty swallowing

 

 

Loss of balance

 

 

Leg weakness

 

1 points

 

QUESTION 5

 

What are the major differences between ALS and MS, physiologically? Describe any pathological differences you find in your research.

 

 

 

Path: pWords:0

1 points

 

QUESTION 6

 

Scott has a positive Babinski reflex. What is the significance of this? What does a positive Babinski reflex mean in adult patients?

 

 

 

Path: pWords:0

1 points

 

QUESTION 7

 

ALS stands for Amyotrophic Lateral Sclerosis. What does “amyotrophic” mean? What is happening to the body (physiologically) if it is experience “amyotrophic” changes?

 

 

 

Path: pWords:0

1 points

 

QUESTION 8

 

ALS stands for Amyotrophic Lateral Sclerosis. What is the word “lateral” referring to in this case?

 

 

The symptoms only affect one side of the body.

 

 

The disease only affects the lateral part of the body.

 

 

The neurodegeneration affects the lateral columns of the spinal cord.

 

 

The neurodegeneration affects the lateral portion of the cerebrum.

 

1 points

 

QUESTION 9

 

The motor neurons affected by ALS are found in the spinal nerves and peripheral branches of those spinal nerves only.

 

True

 

False

 

1 points

 

QUESTION 10

 

Which of the following statements regarding ALS is true?

 

 

ALS cannot be cured, but medication can stop the progression and sometimes reverse the effects of ALS.

 

 

The familial type of ALS is the most common and accounts for 80% of all ALS cases in the U.S.

 

 

The average survival time for a patient diagnosed with ALS is 20-25 years post-diagnosis.

 

 

Diagnosing ALS can involve a spinal tap, electromyography, X-rays, MRI, muscle and nerve biopsies, and blood tests.

 

1 points

 

QUESTION 11

Russell is 72 years old and is still working part-time as a professor. He has noticed some arm and hand shaking in the past year, but assumed it must be related to low or high blood sugar levels because he has had some issues with that in the past. However, the shaking/twitching has become more consistent lately and does not seem to be correlated with his diet. Russell’s doctor said that the stress of his job could be the problem, so he took the entire summer off from teaching.

 

When he returned to work in the fall, Russell and his students noticed that his handwriting has become nearly illegible. Drinking a cup of coffee without spilling had also become a challenge. Russell returned to his doctor, who performed a physical exam and a few tests. Here are the notable results: shuffling gait, mild bradykinesia, mild voice tremor, intermittent rigidity of the limbs, and normal EEG.

 

If Russell is having symptoms in his upper extremities, lower extremities, and his speech is slurred, which of the following body regions is most likely experiencing a pathology?

Cranial nerves

Peripheral nerves

Brain and spinal cord

Spinal nerves

1 points

 

QUESTION 12

 

Russell’s physician suspects that he may have Parkinson’s disease. List at least two other diagnoses that could fit Russell’s history and test results.

 

 

 

Path: pWords:0

1 points

 

QUESTION 13

 

Which of Russell’s physical exam findings could be related to a brain condition?

 

 

 

Path: pWords:0

1 points

 

QUESTION 14

 

Shuffling gait is often associated with Parkinson’s disease. Which of these symptoms is NOT another common sign of Parkinson’s disease?

 

 

Bradykinesia

 

 

Facial masking

 

 

Rigidity

 

 

Babinski reflex

 

1 points

 

QUESTION 15

 

Russell’s physician decides to follow-up with an MRI. If he does have Parkinson’s disease, his MRI may show degeneration in which part of the brain?

 

 

Corpus callosum

 

 

Frontal lobe

 

 

Wernicke’s area

 

 

Substantia nigra

 

1 points

 

QUESTION 16

 

Parkinson’s disease involves the loss of a particular neurotransmitter. Which neurotransmitter is involved and how is it associated with the motor symptoms of Parkinson’s disease?

 

 

 

Path: pWords:0

1 points

 

QUESTION 17

 

Which of the following is NOT a treatment option for Parkinson’s disease?

 

 

Radiation

 

 

Antidepressant medications

 

 

Levodopa

 

 

Deep brain stimulation

 

1 points

 

QUESTION 18

 

If Russell is diagnosed with Parkinson’s disease and chooses not to pursue treatment, what is his prognosis?

 

 

 

Path: pWords:0

1 points

 

QUESTION 19

 

What does the term “neurodegenerative” mean? Briefly describe this term in your own words. (Do not copy a definition.)

 

 

 

Path: pWords:0

1 points

 

QUESTION 20

 

Which of the following statements is true regarding Parkinson’s disease?

 

 

Brain imaging typically shows degeneration of neurons in the temporal lobe.

 

 

It is possible to reverse the effects of Parkinson’s disease.

 

 

Parkinson’s disease is typically diagnosed before 40 years of age.

 

 

The loss of neurons is often accompanied by the necrosis of astrocytes and an increase in microglia.