Scenario B Term Clarification 1. Agitation: unpleasant state of extreme arousal, increased tension and irritability 2.

Severe memory impairment: loss of memory 3. Disorientation: state of mental confusion as to time, place and identity 4. Hallucination: sensory experience of something that does not exist outside of the mind 5. stroke: sudden weakness to one part of the body due to the interruption of blood flow to the brain 6. MMSE : mini mental state examination 7. Neuropsychiatric examination 8. Frontal lobe atrophy:pengecilan pada sel sel neuron pada lobus frontalis Problem Identification 1. Mrs Amis, 79 years old housewife, graduated from grade school, was brought to the IGD because of agitation without any cause. 2. From alloanamnese there was severe memory impairment, disorientation and hallucination. 3. Examinations: BP 180/100, MMSE result 18, CT scan shows frontal lobe atrophy. Problem Analysis 1. What is the anatomy, physiology of the central and peripheral nervous system? 2. What is the etiology of agitation? 3. Mechanism of agitation? 4. Etiology and mechanism of severe memory impairment? 5. Etiology and mechanism of disorientation? 6. Etiology and mechanism of hallucination? 7. Correlation between chief complaint and additional complaints? 8. Interpretation of physical exams and correlation with complaints? 9. Interpretation of neuropsychiatric examination? 10. Mechanisme of frontal lobe atrophy? 11. Correlation of neuropsychiatric examination with complaints? 12. How is the progression of the disease since one year ago? 13. How to make the diagnosis for this case? 14. Differential Diagnosis? 15. Working diagnosis? 16. Etiology and epidemiology? 17. Management (pharmacology, non pharmacology)? 18. Prognosis? 19. Complication? 20. KDU? Hypothesis Mrs Amis, 79 year old house wife is suffering from agitation, severe memory impairment, hallucination, disorientation due to Alzheimer induced dementia.