For the pass this assignment will describe the investigations that are carried out to enable the diagnosis of these physiological disorders. For the merit this assignment will assess possible difficulties involved in the diagnosis from their signs and symptoms.
P3
There are a range of tests and diagnostic procedures is needed to diagnose dementia, but there are several that are fairly commonly used to diagnose dementia.
A GP might refer a person to a specialist to help with the diagnosis. For example, they may be referred to a clinical psychologist which is a healthcare professional who specialises in the assessment and treatment of mental health conditions. Another specialist who the GP might refer someone to is a psychiatrist and they are qualified medical doctor who has further training in treating mental health conditions. The specialist may be based in a memory clinic alongside other professionals who are experts in diagnosing, caring for and advising people with dementia and their families.
A specialist will usually assess the mental abilities using a special questionnaire and one that is widely used is the mini mental state examination (MMSE). This involves being asked to carry out activities such as memorising a short list of objects correctly and identifying the current day of the week, month and year. However the MMSE is not used to diagnose Alzheimer's disease, but it is useful for assessing the level of mental impairment that a person with the condition may have. This helps specialists make decisions about treatment and whether further tests are necessary. The MMSE assesses a number of different mental abilities, including short and long term memory, attention span, concentration, language and communication skills, ability to plan and ability to understand instructions. The MMSE is a series of exercises, each carrying a score with a maximum of 30 points. These exercises include memorising a short list of objects and then repeating the list, writing a short sentence that is grammatically correct, such as "the dog sat on the floor", correctly answering time-orientation questions, such as identifying the day of the week, the date or the year. Test scores may be influenced by a person's level of education. For example, someone who cannot read or write very well may have a lower score, but they may not have dementia. Similarly, someone with a higher level of education may achieve a higher score, but still have dementia.
To rule out other possible causes of the symptoms and look for possible signs of damage caused by Alzheimer's disease, the specialist may recommend having a brain scan and these could be a computerised tomography (CT) scan, where several X-rays of the brain are taken at slightly different angles and a computer is used to put the images together or they could get a magnetic resonance imaging (MRI) scan where a strong magnetic field and radio waves are used to produce detailed images of the inside of the brain. Other types of scan, such as a single photon-emission computed tomography (SPECT) scan or a positron emission tomography (PET) scan.
A person with suspected dementia may have blood tests to check their overall level of health. These blood tests can also rule out other conditions that may be responsible for their symptoms, such as thyroid hormones and vitamin B12 levels.
There are no definitive test to diagnose osteoarthritis in the hip but the GP will suspect it if the person is 45 years of age or older, have joint pain that gets worse the more you use your joints or they have stiffness in your joints in the morning that lasts less than 30 minutes, or no stiffness at all.
To diagnose osteoarthritis, the doctor will collect information on personal and family medical history, perform a physical examination and order diagnostic tests. Further tests such as X-rays or blood tests are not usually necessary to confirm a diagnosis of osteoarthritis, although they may be used to rule out other possible causes of the symptoms, such as rheumatoid arthritis or a fractured bone. X-rays can also allow doctors to assess the level of damage to the joints but this is rarely helpful as the extent of damage visible on an X-ray isn’t a good indicator of how severe the symptoms really are.
During the physical examination the doctor will examine the joints and test their range of motion. He will be looking for areas that are tender, painful or swollen as well as signs of joint damage. The doctor will examine the position and alignment of the neck and spine. A diagnosis of osteoarthritis may be suspected after a medical history and physical examination is done. Blood tests are usually not helpful in making a diagnosis. However, the following tests may help confirm it, a joint aspiration which is where the doctor will numb the affected area and insert a needle into the joint to withdraw fluid. The fluid will be examined for evidence of crystals or joint deterioration. This test can help rule out other medical conditions or other forms of arthritis. The doctor might also get and X-ray because they can show damage and other changes related to osteoarthritis to confirm the diagnosis. Also the doctor might get and magnetic resonance imaging (MRI) which will provide a view that offers better images of cartilage and other structures to detect early abnormalities typical of osteoarthritis.
M1
Some of the possible difficulties involved in the diagnosis of Alzheimer's from their signs and symptoms could be that if the person has short term memory loss then it doesn't actually mean that they have got dementia. If someone struggle with their language then they could have developed a stutter or they may have had a stroke and so this would mean that they probably won't have dementia. If the person starts to have problems with keeping track of everything then they might just be unorganised and if they misplace items then again they might just be clumsy and forget where they put things. A change in a person's mood could be because of several reasons such as menopause, pre-menstrual tension or just generally in a bad mood. If a person’s starts to lose initiative then they could be depressed or have a low self-esteem. Also if a person has a change in personality then this could also be because of a number of reasons such as personal problems at home.
If a GP suspects that a person has got osteoarthritis and the person says that they are in pain or tenderness then it could be something else such as a dislocated hip, or broken hip and it doesn't necessarily mean that it is osteoarthritis. People with osteoarthritis of the hip sometimes have problems walking. Diagnosis can be difficult at first. That's because pain can appear in different locations including the groin, thigh, buttocks or knee. The pain can be stabbing and sharp or it can be a dull ache, and the hip is often stiff. The joints may not have formed properly. This is increasingly thought to be to blame when osteoarthritis develops when a person is young or in midlife there are often problems with the shape of the bones in the hip joint, which may be inherited. There may be genetic defects in the cartilage or possibly in the immune system, making it react abnormally to damage in the joint. The person may be putting extra stress on his or her joints, either by being overweight or through activities that involve the hip such as running or other intensive weight-bearing sports.
References
http://www.nhs.uk/Conditions/Alzheimers-disease/Pages/Diagnosis.aspx http://www.nhs.uk/Conditions/Osteoarthritis/Pages/Diagnosis.aspx http://www.arthritis.org/about-arthritis/types/osteoarthritis/diagnosing.php http://www.sciencedaily.com/releases/2011/05/110531084629.htm http://www.alz.co.uk/info/early-symptoms