Reference no: EM133725711

Assignment:

Mark is 75 year old male who lives with his wife and who accompanied him to the appointment. He is a war veteran and retired. He is a non-insulin dependent diabetic and has hypertension. He is managed on medications for both of these disorders. He has a history of UTIs. He also suffers from arthritis and a bad back for which he recently had back surgery. He was discharged from the hospital to a rehab center where he received physical therapy to get on his feet again. He was discharged from the rehab two days ago. He struggled with the rehab and was provided pain medications to get through his therapy sessions.

He presents today with the following disturbances which have caused him great distress since he is usually up-beat and active. Lately he is not interested in moving and feels sluggish sometimes. He feels depressed and does not enjoy his hobbies. He cannot seem to concentrate or focus. This changes throughout the day. While he believes his mood started to deteriorate when he heard that he had to have surgery for his back, his poor attention just started prior to his discharge from the rehab. He sometimes is unaware of his surroundings and has disorganized thinking. He just want to sleep all day and feels worthless. He wonders if he would be better off dead. His wife noted that he is "different, disoriented at times".

1. What is the differential diagnosis and why?

2. What are the key element in your assessment for this patient to get to the diagnosis?

3. Describe your diagnosis (may be more than one).