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There are a couple of things that might need further clarification for this week’s Discussion regarding
identifying/applying a theory and developing a research question related to your proposed research
project in week 5.
First, please make note that the instruction point for the Discussion that states,
Using the Quick Guide to Theories—intersectionality, social learning, self-efficacy, ethics of
care, ecological systems, empowerment—select one of the six theories to use for your
study”, should instead read, “Using the Carousel of Theories required media resource,
which provides discussion on intersectionality, social learning, self-efficacy, ethics of care,
ecological systems, empowerment, select one of the six theories to use for your study.”
As well, for the peer response prompts, you should provide feedback that responds to the
discussion posts of your two selected peer. See clarification on what is expected below:
Respond to two teammates by:
Providing feedback on a strength of your peers proposed research project, theory and/or
research question(s).
Asking two or more open-ended questions to inspire better research questions – ask your
peers two or more questions that might help them to think more about the research
question(s) they posed. For example, “Would you consider asking
…………………………..instead as this might help better support your theory? What do you
think?” or “What if you asked your research question like this,
……………………………………. This would then better support a qualitative study in my
view. Are you proposing a qualitative or quantitative study?”
Sharing an insight – share you insight either on the topic of your peer’s research,
insight about developing research questions, and/or research about choosing and
applying a theory.
Making a suggestion – make a suggestion regarding any part of your peer’s ideas,
arguments, theory, research question(s), etc; suggest something that might improve
what your peers have proposed.
Noting a similarity or difference to your posting/proposed project to two other
teammates/researchers with whom you are now familiar.
Support your response posts with evidence from additional research and adhere to the most
recent version of APA documentation.
Research Questions
How does engagement in sex work impact the mental health and wellbeing of mothers?
This question explores the general psychological impacts of sex work on sex-working mothers. It seeks to capture both the positive and negative outcomes. It intrigues an in-depth examination of multiple factors that impact mental health.
What role does stigma play in shaping the psychological experiences of sex-working mothers?
Stigma is a pervasive concern among the sex workers (Grittner & Walsh, 2020). Answering this research question will allow the researcher to uncover the strategies to improve psychological wellbeing.
Focus Research Ability, and Relevance and Specificity of the Research Questions
Each research question is focused on a specific aspect of the psychological impacts of sex work among the sex working mothers. It promises a targeted investigation into the various dimensions of mental health. These questions can be addressed through either qualitative or quantitative research methods. Hence, they are researchable. Furthermore, these questions focus on the intersection of sex work and motherhood, thus, their relevance. They provide a specific direction to guide the researcher towards insights and actionable recommendations.
Theory: Social Systems Theory
This theory holds that an individual exists as a part of interconnected systems. The different components and interconnections impact one another. This theory is relevant to the topic of discussion as it allows the researcher to explore the complex relationship between the individual sex-working mothers, the family component, the community, and the larger societal sanding (Becvar et al., 2023). In each system, some stressors and resources may impact the psychological wellbeing of the sex-working mothers. This theory emphasizes the importance of looking at an individual in the context of their environment. Thus, it allows the researcher to delve into a comprehensive exploration of multiple factors that may impact the study population.
References
Becvar, R. J., Becvar, D. S., & Reif, L. V. (2023). Systems theory and family therapy: A primer. Rowman & Littlefield.
Grittner, A. L., & Walsh, C. A. (2020). The role of social stigma in the lives of female-identified sex workers: A scoping review. Sexuality & Culture, 24(5), 1653-1682. https://doi.org/10.1007/s12119-020-09707-7
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An Example of What we Handle
Sample Response 1
Response to Sam
Hello Sam! I enjoyed reading your discussion post. You have clearly identified two researchable
questions focusing on a specific study population, the Spanish Mexican American gender diverse
individuals living in Albuquerque, New Mexico. However, I have noticed that this study
population is not aligned with the study population identified by McCloskey et al. (2021).
McCloskey et al. (2021) focus on sex-working mothers. Therefore, the following research topic
could better align with the said study population:
What are the lived experiences of sex-working mothers?
Indeed, the transgender theory suits your approach to the study. According to Nagoshi and
Brzuzy (2010), transgender theory is a theoretical approach to the nature of gender and gender
identity in exploring the lived experiences of transgender and transsexual people. It incorporates
the self and socially constructed aspects of identities through the lived experiences of the people.
Thus, it is suitable to address the topic.
References
McCloskey, R. J., Karandikar, S., Reno, R., & España, M. (2021). The feminist ethic of care:
Mothering among sex workers in Mumbai. Affilia: Journal of Women and Social Work 36(1),
43–61. https://doi.org/10.1177%2F0886109920939053
Nagoshi, J. L., & Brzuzy, S. I. (2010). Transgender theory: Embodying research and
practice. Affilia, 25(4), 431-443. https://doi.org/10.1177/0886109910384068
Sample Response 2
Hello Tierra!
You have provided a specific research question covering the study population, as highlighted in
McCloskey et al. (2021). Other possible research questions you could cover in this context
include:
What are the impacts of sex work on the mental health and well-being of sex-working mothers?
Sex workers experience multiple challenges in line with their duties. First, they are at a high risk
of violence perpetrated by their customers and strangers. This question will help explain the
complex dynamics and challenges sex-working mothers face, acknowledging the intersection of
the participants’ roles as both sex workers and mothers (Zhang et al., 2017).
The second potential question to explore is:
What are the coping mechanisms employed by sex-working mothers to manage the emotional
and psychological challenges associated with their dual role?
This research question delves deeper into the resilience and coping strategies sex-working
mothers employ. Examining these research questions will allow you to navigate the emotional
and psychological landscape of the lives of sex-working mothers.
References
McCloskey, R. J., Karandikar, S., Reno, R., & España, M. (2021). The feminist ethic of care:
Mothering among sex workers in Mumbai. Affilia: Journal of Women and Social Work 36(1),
43–61. https://doi.org/10.1177%2F0886109920939053
Zhang, L., Li, X., Wang, B., Shen, Z., Zhou, Y., Xu, J., … & Stanton, B. (2017). Violence,
stigma and mental health among female sex workers in China: A structural equation
modeling. Women & health, 57(6), 685-704. https://doi.org/10.1080/03630242.2016.1186781
The research question is a guideline for the study implementation. Research questions are carefully selected based on issues of significance to society and to fill the knowledge gap in the literature. The theory provides the foundation upon which research is premised.
Research Questions
How does engagement in sex work impact the mental health and wellbeing of mothers? Sex workers face multiple occupational health risks, such as substance abuse, violence and high-risk sexual behaviors that take a toll on mental health. Despite the high need for healthcare services, sex workers encounter stigma and barriers to accessing healthcare services. Furthermore, stigma and discrimination are key issues that sex workers have to encounter in their daily lives and when they try to access healthcare services (Martín‐Romo et al., 2023). This research question intrigues an in-depth examination of multiple factors impacting the mental health and wellbeing of sex-working mothers. What role does stigma play in shaping the psychological experiences of sex-working mothers? Stigma is a key problem among sex-working mothers. Sex-working mothers stare at rejection and discrimination from people close to them, including friends and family. Solation among this population may contribute to loneliness and aggravate the challenges of parenting. Stigma may prevent sex-working mothers from various support services, including counselling and healthcare services (Martín‐Romo et al., 2023). Furthermore, sex-working mothers may fear judgment from the people close to them. The fear of judgment also stands in the way of sex-working mothers from accessing the much-needed support services that could otherwise improve their general health and wellbeing, 3 targeting them and their children. Answering this question will provide further insights into strategies to improve psychological wellbeing.
Social Systems Theory
Systems theory looks at society as a complex arrangement of elements encompassing people and believes they relate to a whole nation or community. With its origin in the 19th century, the study looking at society as a social system has been a long practice in social sciences. This theory provides that an individual does not exist as a standalone person but as part of an interconnected system (Valentinov & Hajdu, 2021).
Integrating.
The system in itself can be seen as a machine with various parts with specific functions supporting each other. This topic is relevant to the discussion since sex-working mothers exist in society as part of the community in which they live. Particularly, sex-working mothers exist first as mothers, members of a family, and a community at large. The actions of each part of the society across the levels mentioned impact one another. For instance, discrimination by the family members and members of their community impacts the health and well-being of the sex working mothers (Treloar et al., 2021). In other words, the stressors and resources in each system may impact the psychological well-being of the sex-working mother. Notably, this theory highlights the importance of assessing an individual in the context of their environment. In this light, it allows the researcher to uncover the multiple factors impacting the study population.
Conclusion
The research questions provided above will help the researchers uncover in-depth information about sex-working mothers that can be used to design strategies to improve their health and well-being. The theory provides the groundwork for a study. The social systems 4 theory is relevant to the discussion since it considers a person as part of interconnected components of the larger society.
5 References
Martín‐Romo, L., Sanmartín, F. J., & Velasco, J. (2023). Invisible and stigmatized: A systematic review of mental health and risk factors among sex workers. Acta Psychiatrica Scandinavica,148, 255–264.wileyonlinelibrary.com/journal/acps255https://doi.org/10.1111/acps.13559 Treloar, C., Stardust, Z., Cama, E., & Kim, J. (2021). Rethinking the relationship between sex work, mental health and stigma: a qualitative study of sex workers in Australia. Social Science & Medicine, 268, 113468. https://doi.org/10.1016/j.socscimed.2020.113468 Valentinov, V., & Hajdu, A. (2021). Integrating instrumental and normative stakeholder theories: a systems theory approach. Journal of Organizational Change Management, 34(4), 699- 712. https://doi.org/10.1108/JOCM-07-2019-0219
Concept Map Template
Primary Diagnosis: ___________________________________________________________
1. Describe the pathophysiology of the primary diagnosis in your own words. What are the
patient’s risk factors for this diagnosis?
Pathophysiology of Primary Diagnosis
Causes Risk Factors (genetic/ethnic/physical)
2. What are the patient’s signs and symptoms for this diagnosis? How does the diagnosis impact
other body systems and what are the possible complications?
Signs and Symptoms – Common presentation How does the diagnosis impact each body
system? Complications?
3. What are other potential diagnosis that present in a similar way to this diagnosis
(differentials)?
4. What diagnostic tests or labs would you order to rule out the differentials for this patient or
confirm the primary diagnosis?
5. What treatment options would you consider? Include possible referrals and medications.
LEARNING RESOURCES
Lecturio Resources
Review the following Video Resources and Content Pages in the Lecturio Platform by
clicking button below labeled Load Week 7: Learning Resources in a new window.
Ischemic Stroke (3:28 min)
Hemorrhagic Stroke (8:01 min)
Embolism (9:42 min)
Transient Ischemic Attack (TIA): Definition and Causes (Nursing) (4:21 min)
Acute Headache: Meningitis and Temporal Arteritis (6:52 min)
Acute Headache: Hypertensive Urgency and Cluster Headache (Horton’s
Syndrome) (4:53 min)
Acute Headaches: Venous Sinus Thrombosis (3:12 min)
Sub-Acute Headache, Chronic Headache and Migraine (6:00 min)
Other Types of Headache (3:19 min)
Brain Tumor and Tension Headaches (4:21 min)
Seizures: Types (5:33 min)
Epilepsy and Febrile Seizures (4:16 min)
Movement Disorders: Introduction (8:45 min)
Altered Mental Status and Coma: Introduction (6:48 min)
Spinal Cord Pathology: Introduction (6:34 min)
Overview of CNS Inflammatory Diseases (6:47 min)
Anomalies of the Aging Brain: Parkinson’s Disease (7:16 min)
Anomalies of the Aging Brain: Dementia (Alzheimer’s Disease) (2:55 min)
If you have any technical issues, please contact the Customer Care Team at 1-800-925-
3368.
Required Resources
Document: NURS 6501 Concept Map Template Download NURS 6501 Concept Map
Template(Word document)
Supplementary Resources
Note: These readings are intended to serve as supplementary to the Lecturio content
provided in this course. Please refer/review these supplementary resources should you
need help in reinforcing concepts and in preparation for completing this week’s
Assessments.
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: the biologic basis for
disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
o Chapter 15: Structure and Function of the Neurologic System
o Chapter 16: Pain, Temperature Regulation, Sleep, and Sensory Function
(stop at Sleep); Summary Review
o Chapter 17: Alterations in Cognitive Systems, Cerebral Hemodynamics, and
Motor Function (start at Acute confusional states and delirium) (stop at
Alterations in neuromotor functions); (Parkinson’s Disease); Summary
Review
o Chapter 18: Disorders of the Central and Peripheral Nervous Systems and
the Neuromuscular Junction (stop at Degenerative disorders of the spine);
(start at Cerebrovascular disorders) (stop at Tumors of the central nervous
system); Summary Review
Chin, L. S. (2018). Spinal cord injuriesLinks to an external site.. Retrieved
from https://emedicine.medscape.com/article/793582-overview#a4
Spinal Cord Injuries: Practice Essentials,
Background, Anatomy
Spinal cord injury (SCI) is an insult to the spinal cord
resulting in a change, either temporary or permanent, i…
Week 7 Assignment needs to have these included.
Need an introduction; need to have a purpose statement in the introduction of the paper about the paper; in the references
have the first line to the margin and indent all other lines
Week 7 Assignment Rubrics and Info
NEUROLOGICAL DISORDERS
In this exercise, you will complete a MindMap Template to gauge your understanding of
this week’s content. Select one of the possible topics provided to complete your
MindMap Template.
Stroke
Multiple sclerosis
Transient Ischemic Attack
Myasthenia gravis
Headache
Seizure disorders
Head injury
Spinal cord injury
Inflammatory diseases of the musculoskeletal system
Parkinson’s
Alzheimer’s
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
BY DAY 7 OF WEEK 7
Submit your MindMap Template by Day 7 of Week 7.
NURS_6501_Week 3, 5, 7, 9_Mind Map Assignment_Rubric
Criteria Ratings Pts
This criterion is
linked to a
Learning
OutcomeSelect
one of the
possible topics
provided and
complete the
MindMap
Template.
1) Describe the
pathophysiology
of the primary
diagnosis in your
20 to >17.0 pts
Excellent
A thoroughly
completed MindMap
Template with a
selected topic was
submitted. The response
accurately and
thoroughly describes in
detail the
pathophysiology of the
primary diagnosis in the
student’s own words.
The response accurately
and thoroughly explains
in detail the patient’s
risk factors for this
17 to >14.0 pts
Good
A completed
MindMap Template
with a selected topic
was submitted. The
response describes
the pathophysiology
of the primary
diagnosis in the
student’s own words.
The response explains
the patient’s risk
factors for this
diagnosis.
14 to >12.0 pts
Fair
An inaccurately
complete or vague
MindMap Template
with a selected topic
was submitted. The
response inaccurately
or vaguely describes
the pathophysiology of
the primary diagnosis
in the student’s own
words. The response
inaccurately or vaguely
explains the patient’s
risk factors for this
diagnosis.
12 to >0 pts
Poor
An incomplete
MindMap Template
with a selected topic
was submitted, or is
missing. The response
inaccurately and
vaguely describes the
pathophysiology of the
primary diagnosis in the
student’s own words, or
is missing. The response
inaccurately and
vaguely describes the
patient’s risk factors for
this diagnosis, or is
20 pts
own words. What
are the patient’s
risk factors for
this diagnosis?
diagnosis. missing.
This criterion is
linked to a
Learning
Outcome2) What
are the patient’s
signs and
symptoms for this
diagnosis? How
does the diagnosis
impact other body
systems and what
are the possible
complications?
20 to >17.0 pts
Excellent
The response accurately
and thoroughly
describes in detail the
patient’s signs and
symptoms for this
diagnosis. The response
accurately and
thoroughly describes in
detail how this
diagnosis might impact
other body systems and
their possible
complications.
17 to >14.0 pts
Good
The response
accurately describes
the patient’s signs and
symptoms for this
diagnosis. The
response accurately
describes how this
diagnosis might
impact other body
systems and their
possible
complications.
14 to >12.0 pts
Fair
The response
inaccurately or vaguely
describes the patient’s
signs and symptoms
for this diagnosis. The
response inaccurately
or vaguely describes
how this diagnosis
might impact other
body systems and their
possible complications.
12 to >0 pts
Poor
The response
inaccurately and
vaguely describes the
patient’s signs and
symptoms for this
diagnosis, or is missing.
The response
inaccurately and
vaguely describes how
the diagnosis might
impact other body
systems and their
possible complications,
or is missing.
20 pts
This criterion is
linked to a
Learning
Outcome3) What
are other potential
diagnosis that
present in a
similar way to this
diagnosis
(differentials)?
20 to >17.0 pts
Excellent
The response accurately
and completely
describes in detail the
potential diagnoses that
present in a similar way
to the diagnosis
provided.
17 to >14.0 pts
Good
The response
accurately describes
the potential
diagnoses that
present in a similar
way to the diagnosis
provided.
14 to >12.0 pts
Fair
The response
inaccurately or vaguely
describes the potential
diagnoses that present
in a similar way to the
diagnosis provided.
12 to >0 pts
Poor
The response
inaccurately and vaguely
describes the potential
diagnoses that present in
a similar way to the
diagnosis provided, or is
missing.
Interview Questions
Please provide some background information about yourself, such as age, education, and cultural
background?
Could you share your experiences of being a mother while engaging in sex work?
In what ways have you experienced stigma or discrimination related to your involvement in sex
work and being a mother?
How do you cope with or respond to negative societal judgments?
Are there specific challenges or stressors related to being a mother and a sex worker that affect
your mental health?
Can you discuss the support systems you have in place, both personally and within the sex work
community, to cope with challenges?
What strategies or coping mechanisms do you employ to manage stress, anxiety, or other mental
health challenges?
How do you perceive the impact of your involvement in sex work on your children, if
applicable?
Selection Criteria
The interview questions provided above are structured to help the researcher build a
rapport with the respondents. The questions begin from a less sensitive topic, such as
demographic information, and transition to more sensitive issues regarding the participant’s
lives. It provides the respondents with a chronological approach, allowing them to open up
gradually (Smith, 2021). Sex work as a social issue is interconnected.
Sample Size and Population
Sex-working mothers, regardless of their ethnic backgrounds, will be recruited in this
study. A small sample size of 24 will be selected due to the resource constraints and to allow
thematic saturation.
Duration of Administration
Interviews will last approximately 45 minutes to allow the respondents to share their
experiences.
Data Management
Open-ended interviews will be used to collect data. This instrument is suitable since it
allows the researcher to generate in-depth information about the experience of a people (Showkat
& Parveen, 2017). Thematic analysis will be utilized as the appropriate data analysis technique.
It will allow the researcher to identify patterns in the data and explore the common themes.
Conclusion
My research focuses on the psychological impacts of social work and how stigma is
implicated. The questions are designed to help build rapport between the researcher and
participants. The interview is used to generate in-depth information, which will be analyzed
using thematic analysis.
References
Showkat, N., & Parveen, H. (2017). In-depth interview. Quadrant-I (e-text), 1-9.
http://www.uop.edu.pk/ocontents/Lecture%204%20indepth%20interview.pdf
Smith, T. (2021). Qualitative and quantitative research. Salem Press Encyclopedia
Concept Map
Primary Diagnosis: Parkinson’s
1. Describe the pathophysiology of the primary diagnosis in your own words. What are the
patient’s risk factors for this diagnosis?
Pathophysiology of Primary Diagnosis
The pathophysiology of Parkinson’s disease begins with the loss of dopaminergic neurons in
the SNpc. The studies involving families with Parkinson’s disease have led to a breakthrough
in the pathophysiology of this condition. According to Zafar and Yaddanapudi (2023), the
pathophysiology of Parkinson’s disease is associated with the accumulation of alpha-synuclein
in the various regions of the brain, particularly the substantial nigra, causing degeneration and
resulting dopamine loss in the basal ganglia that are responsible for controlling the muscle
movement and tone. This source recognizes that alpha-synuclein protein accumulation
operates as a factor secondary to
the genetic predisposition of a patient. Researchers have been drawn to examining an
infectious aetiology known to trigger this alpha syncline accumulation. Zafar and
Yaddanapudi (2023) contend that the knowledge about Parkinson’s disease is evolving. Thus,
it is imprudent to confine the aetiology of this condition to a lack of dopamine in the
substantia nigra. The pathophysiology of this condition appears to be broader and with the
implication of non-hereditary causes of alpha-synuclein deposition in the brain.
Causes Risk Factors (genetic/ethnic/physical)
The exact cause of Parkinson’s disease is
unknown. However, several factors are
known to contribute to the development of
There is a broad range of risk factors for
Parkinson’s disease, including age. This
condition is rarely experienced among young
3
this condition. Genetics is the first factor.
Research studies have revealed specific
genetic complications that may cause
Parkinson’s disease (Bloem et al., 2021).
Although this cause is uncommon, it occurs
among patients with a family history of
Parkinson’s disease. Similarly, gene
variations elevate the risk of developing
Parkinson’s Disease.
Environmental triggers are also possible
causes of Parkinson’s disease. Exposure to
some toxins or environmental factors may
elevate the risk of later Parkinson’s disease
development. However, the risk is small.
adults. Its onset is majorly associated with
middle or late life. The risk of developing
Parkinson’s disease increases with increase in
age. Normally, this problem develops among
people aged 60 years or older. If a younger
person develops this condition, it is advisable
to seek genetic counselling to help in
decision-making in family planning.
The social conditions and side effects among
patients differ depending on age. Thus, these
factors require special consideration.
Genetics is another risk factor for Parkinson’s
disease. People with a family history of
Parkinson’s disease have higher odds of
developing this condition. The more relatives
with Parkinson’s disease a person has, the
higher the risk of developing this condition.
Sex is also a risk factor. Notably, men are
more likely to develop Parkinson’s disease
than their female counterparts.
Prolonged exposure to toxins, including
herbicides and pesticides, elevates the risk of
Parkinson’s disease.
4
2. What are the patient’s signs and symptoms for this diagnosis? How does the diagnosis impact
other body systems and what are the possible complications?
Signs and Symptoms – Common presentation How does the diagnosis impact each body
system? Complications?
The signs and symptoms of Parkinson’s
disease are often expressed differently among
the patients. Early symptoms are expressed as
mild and may go unnoticed (Váradi, 2020).
Normally, the symptoms begin in one side of
the body and worsen on that side even after
the symptoms start expressing in limbs on
both sides. The common symptoms recorded
among patients with this condition include
tremors.
A tremor can be described as the rhythmic
shaking that normally occurs in a limb. The
patients may rub their thumb and forefinger
back and forth. Performing tasks alleviates
the shaking (Váradi, 2020). Another symptom
is slowed movement, scientifically termed
bradykinesia.
As the symptoms progress, the disease may
If ineffectively managed, Parkinson’s
Disease may cause cognitive problems
manifested as thinning difficulties. The
patients may experience complications,
including dementia (Gonzalez-Latapi et al.,
2021). These complications are uncommon
during the early stages of Parkinson’s disease.
Other possible complications that may occur
among the patients include depression and
emotional changes. Depression may develop
even during the early stages of the disease.
Employing interventions to address
depression may make it easy for the patients
to handle the other challenges associated with
Parkinson’s disease. The patients may
develop emotional damage, which is
expressed in the form of fear, anxiety and
reduced motivation. Patients may develop
5
slow movement, making it difficult and time-
consuming for the patients to perform
common tasks. For instance, their steps may
become shorter when they walk. Secondly, it
may be challenging to get out of the chair.
Furthermore, one may shuffle their feet when
they walk. Patients may develop rigid
muscles.
Muscle stiffness can occur in any body part.
This symptom is followed by pain in the stiff
muscles and limited range of motion. The
patients experience impaired posture and
balance. Particularly, the posture becomes
stooped. These symptoms elevate the risk of
falls as the patients develop challenges with
balancing. Loss of automatic movement is
another possible symptom. The patients may
have reduced ability to perform unconscious
movements, including smiling, blinking, or
swinging their arms when they walk.
Changes in speech are also a possible
symptom of Parkinson’s Disease. The patient
may speak softly or quickly. Similarly, the
complications with swallowing. As the
condition progresses to later stages, saliva
may accumulate in the patient’s mouth due to
slowed swallowing, which may cause
drooling. Chewing and eating problems may
also occur during the last stages of the disease
as it impacts the muscles of the mouth. These
complications may lead to poor nutrition and
choking. Persons with Parkinson’s disease
may develop sleep problems, including
waking up frequently during the night or
waking up early. Rapid eye movement may
also occur. Bladder problems are another
complication that may occur among the
patients. The patient may develop difficulties
controlling urine or urinating. Constipation is
a problem of the gastrointestinal system that
may occur among patients having Parkinson’s
disease. This complication develops as a
result of a slower digestive tract.
Changes in blood pressure are a complication
that patients with Parkinson’s disease may
develop. The patients may feel lightheaded or
6
patients may be hesitant before they talk.
Their speech may become a monotone instead
of their usual speech patterns. Changes in
writing are another key symptom of
Parkinson’s disease. Patients may experience
difficulty in writing as their writing may
appear small.
dizzy when they stand due to a sudden
reduction in blood pressure. Similarly, the
patients may experience problems with their
sense of smell. Specifically, they may have
trouble identifying some orders or differences
between odors . Sexual dysfunction is also
another problem patient with this condition
may develop. The patients may experience
reduced sexual desire or performance. Some
patients may experience pain either in the
whole body or in particular parts.
3. What are other potential diagnosis that present in a similar way to this diagnosis
(differentials)?
Differential diagnosis for Parkinson’s disease include a wide range of neurodegenerative
disorders and hereditary diseases including structural lesions, drugs or toxins, and metabolic
abnormalities.
These conditions include:
Alzheimer’s Disease
Lewy Body Dementia.
Essential Tremor.
7
Cardioembolic Stroke.
4. What diagnostic tests or labs would you order to rule out the differentials for this patient or
confirm the primary diagnosis?
The following diagnostic tests can be utilized:
Magnetic resonance imaging of the brain (MRI brain).
A dopamine transporter scan (DaT scan).
Imaging of the brain (MRI brain).
Blood work.
5. What treatment options would you consider? Include possible referrals and medications.
Pharmacological
Levodopa: the first line pharmacological intervention for symptomatic treatment (Bogetofte et
al., 2020).
Monoamine oxidase (MAO)–B inhibitors: this treatment intervention is a suitable for early
disease.
Anticholinergic agents (eg, trihexyphenidyl, benztropine): the second-line treatment modality
for tremor only.
Referral:
Suppose the symptoms persist despite the treatment plan. In that case, the primary care
provider can refer the patient to a specialist, including a neurologist who specializes in
8
managing conditions impacting the brain and nervous system. Geriatricians, as the name
suggests, specialize in conditions affecting older adults. Parkinson’s disease is a condition
uncommon among young people and hence falls under the geriatricians’ scope of practice.
References
Bloem, B. R., Okun, M. S., & Klein, C. (2021). Parkinson’s disease. The Lancet, 397(10291),
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