Learning Issues

Madam Leong, 82/F

· Osteoarthritis, right Knee replacement

· Used to live alone, now live in nursing home,

· Increased absent-mindedness worrying son - John Leong

· Severe physical and mental deterioration eg memory loss after surgery

· Easily confused (couldn’t recognize own son)

· Stiff movements

· Frequent, painful urination

· Still had knee problems

· Urine like odours (incontinence)

· Social problem (lack of nurses)

To know:

· Past medical history (hypertension?)

· Family history

· Diet

· Lifestyle (alcohol, smoking and exercise)

· Mental health (especially after death of husband)

o Orientation

o Long term and short term memory

o Speech

· Movement

· Medications

· Accidents?

· Urine analysis

o Amount of urine

o Odour

o Pain?

o Colour

o Nature

Differential diagnosis

· UTI

· Renal failure

· Dementia

· Depression

· Alzheimers

· Parkinsons

· Upper motor neuron lesions

· Stoke

· Fever

To be examined

· Mental state

· Urine analysis

· Physical examination (test movements)

· Blood pressure

· Neurological examination

· BMI

· Nutritional status

· Abdomen (tender at pubic area?)

Investigations

· Kidney functions

· Urine examination

· Urine culture

· Blood test

· CT scan?

Learning issues

1. Definition (UTI and Alzheimer’s) - meeeeeeeeeeeeeeeeeeena

2. General structure of genital urinary tract (anatomy) – Irene MAMA

3. Signs and symptoms – akmez the buff man

4. Pathophysiology – hai sherng walauehhhhhhh

5. General causes of cognitive impairment amongst elderly + causes – retard

6. Risk factors: Why are old people prone to UTI? Why are people with dementia more prone to infections due to UTI? Confusion due to UTI or dementia? - tiny

7. Investigation – uncle loh

8. Treatment and management – ching mei

9. Complications – zhi mei

10. Prevention for Alzheimer’s – Thomas the tank engine

11. Impact of dementia on family and society (talk about community support) - shuhaiba