Left justified. 1. Describe the major categories of messenger molecules responsible for neurotransmission. 2. Briefly present the difference in neuronal malfunction in patients with Alzheimer’s disease and in patients with Parkinson’s disease? 3. Complete case study below: Marc is 56-year old male who came to emergency room complaining of depression and poor appetite. • He reported that he had been in good health until 2 weeks earlier when he was fired from his job. • He stated that his appetite decreased significantly, he also has decreased energy and poor concentration. • He also complained of insomnia without any desire to get out of bed. • In fact, his wife would bring his food into the bedroom and feed him. His mental status: • Poor grooming • No other neurological abnormalities. • He is depressed but no thought of homicidal or suicidal ideation. Past medical history: • Negative for surgery, but he was hospitalized at the age of 38 years for an unknown heart-related problem. • He states that marriage is “good”. • He has two adult children who are doing well. • He denies any overseas travels. • He drinks two beers in a week and in the past. • Smokes one pack of cigarettes every three days. • Denies any illegal drug use. • He says: “I have never felt this way before”. While the emergency room doctor was waiting to admit Marc to the psychiatric unit, the laboratory work was ordered to medically clear him. While waiting for the lab results, Marc started to complain of shortness of breath, chest and abdominal pain and was rushed into intensive care unit. His lab results: • White blood cells count was 23,000 (normal 5,000-10,000) • His hematocrit (the ratio of the volume of red blood cells to the total volume of blood) was 21% (normal 40-45%). • His chest X-ray was abnormal and showed right lobe infiltration. His final diagnosis was culture negative endocarditis Note: Endocarditis is an infection of the endocardium, which is the inner lining of your heart chambers and heart valves. Endocarditis generally occurs when bacteria, fungi or other germs from another part of your body, such as your mouth, spread through your bloodstream and attach to damaged areas in your heart. • What is your explanation in regards of differential diagnosis? • What role the complaint as depression played in this case? • What suggestions would you have in order to differentiate organic vs functional causes leading to the alterations in patient’s behavior? Use this or any other example you may have.
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