Discussion Part One (graded)\t\u00a0\t\u00a0\t\u00a0\tC.W. is a tall, thin 78-year-old African American male brought into the office by his son who states that the patient is restless, angry, and has been unable to sleep for the last week. The son indicates that he is very concerned about his father because he lives alone. Also, he is concerned about the “strange”\ufffd symptoms that his father has presented with recently.\t\u00a0\t\u00a0\t\u00a0\tBackground:\t\u00a0\t\u00a0\tC.W. presents as restless, hyperverbal, obnoxious and angry. He expresses himself by periodic yelling. He is unkempt and smells strongly of urine, alcohol and body odor. “\ufffd”\ufffd”\ufffd”\ufffd has an unsteady gait and sways while standing. As you converse with the son, you determine that C.W. was medically separated from military service due to mental health issues after 2 years of active duty that ended in 1947. He has been married and divorced three times over the years. He typically seeks no acute or preventative medical care. ___ was treated by a psychiatrist previously, but he did not like taking the prescribed medications so he stopped taking them and did not keep any further psychiatric appointments.\u00a0\t\u00a0\t\u00a0\t\u00a0\tPMH:\t\u00a0\t\u00a0\tPatient denies any previous diagnoses. However, when asked why he saw a psychiatrist in the past, he tells you that the psychiatrist diagnosed paranoid schizophrenia, but that he does not have any psychiatric diagnoses or problems. He states: “It was just a way for him to make money off me coming in and seeing him and paying the drug companies for me to take all those meds!”\ufffd\t\u00a0\tCurrent medications:\t\u00a0\tDenies prescription medications, over the counter medication, herbal therapies or vitamins.\u00a0\t\u00a0\t\u00a0\tSurgeries:\t\u00a0\t\u00a0\tDenies surgeries\t\u00a0\tAllergies: NKA\t\u00a0\tVaccination History:\t\u00a0\tFlu vaccine: never given\t\u00a0\tPneumovax: never given\t\u00a0\tTetanus: never given\t\u00a0\tHerpes zoster: never given\t\u00a0\t\u00a0\tScreening History:\t\u00a0\t\u00a0\t\u00a0\tLast Colonoscopy was 2012-normal\t\u00a0\tLast dilated retinal and glaucoma exam was 2013\t\u00a0\t\u00a0\t\u00a0\tSocial history and Risk Factors:\t\u00a0\t\u00a0\t\u00a0\tPatient admits to smoking cigarettes and cigars. “\ufffd”\ufffd estimates that he smokes about 1 pack of cigarettes daily for the last 40 years, and 2 cigars each week for the last 30 years.\t\u00a0\tHe states that he drinks a 24 ounce bottle of beer 4-6 times a week. “\ufffd denies drinking wine or hard liquor. “\ufffd”\ufffd.. does admit to smoking marijuana on occasion but does not use other recreational drugs.\tPatient denies falling. You notice some scrapes on his forearms, and when asked, he tells you that he fell yesterday: “I got pretty drunk out fishin’ with friends and fell off my bike trying to ride home”\ufffd. He does not use any assistive devices for ambulation or balance.\t\u00a0\tSignificant ROS:\t\u00a0\tProductive cough with white sputum. Denies hemoptysis.\t\u00a0\tHe answers “No”\ufffd to the PHQ-2 screening questions.\t\u00a0\tFamily history:\t\u00a0\tReports no significant family history\t\u00a0\t\u00a0\t\u00a0\t\u00a0\tDiscussion Part One:\t\u00a0\t\u00a0\tProvide differential diagnoses (DD) with rationale.\tFurther ROS questions needed to develop DD.\tBased on the patient data provided, choose geriatric assessment tools that would be appropriate to use in conducting a thorough geriatric assessment. Provide a rationale on why you are choosing these particular tools.<\/p>\n","protected":false},"excerpt":{"rendered":"
Discussion Part One (graded) \u00a0 \u00a0 \u00a0 C.W. is a tall, thin 78-year-old African American male brought into the office by his son who states that the patient is restless, angry, and has been unable to sleep for the last Read More …<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-230099","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/230099","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/comments?post=230099"}],"version-history":[{"count":0,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/230099\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/media?parent=230099"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/categories?post=230099"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/tags?post=230099"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}