,CẢNH 1:

D : Hello,___tên__ Can I help you ?

P: Recently, my memory has deteriorated a lot. I forgot where I put things or something. And
sleep is also disturbed.
Gần đây, trí nhớ của tôi đã kém đi rất nhiều. Tôi quên mất nơi tôi để đồ vật hay thứ gì
đó. Và giấc ngủ cũng bị xáo trộn.
D: That sounds serious. Any other symptoms?
Nghe có vẻ nghiêm trọng đấy. Có triệu chứng nào khác không?
P: Mood or personality also changes: easily angry, depressed, anxious and afraid. I was also
disoriented and easily confused.
Tâm trạng hay tính cách cũng thay đổi: dễ tức giận, chán nản, lo lắng và sợ hãi. Tôi
cũng bị mất phương hướng và dễ bối rối.
D: Do you drink a lot of alcohol or are there any cardiovascular risks?
Bạn có uống nhiều rượu hoặc có nguy cơ mắc bệnh tim mạch không?
P: Because of the nature of my work, I drink a lot of alcohol and have high blood pressure.
Vì tính chất công việc nên tôi uống nhiều rượu và bị cao huyết áp.
D: Hmm sorry but based on those early symptoms, this is Alzheimer's disease.
Xin lỗi nhưng dựa vào những triệu chứng ban đầu đó thì đây là bệnh Alzheimer
P: Oh my. What is the cause of the disease, doctor?
Nguyên nhân của bệnh là gì vậy bác sĩ?
D: In short, the accumulation of a protein in the brain leads to brain cells gradually dying.
Alcohol is also the cause of changes in the brain.
Nói ngắn gọn là do sự tích tụ của một loại protein trong não dẫn đến tế bào não chết
dần. Và rượu bia cũng là nguyên nhân gây ra những thay đổi trong não.
P: Ohh that's bad, so can it be cured?
ohh thật tệ, vậy bệnh có thể trị được không ?
D: I regret to inform you that Alzheimer's is a progressive disease and there is no cure. But don't
worry too much, we can slow down the progression of the disease.
Tôi rất tiếc phải thông báo cho bạn rằng bệnh alzheimer là bệnh tiến triển nặng dần và
không có thuốc điều trị khỏi bệnh. Nhưng đừng quá lo lắng, chúng ta có thể làm chậm
lại sự tiến triển của bệnh.
P: So what should I do, doctor?
Vậy tôi nên làm gì đây bác sĩ?
D: First, you need to do a clinical examination. I will then prescribe you a cholinesterase
inhibitor as well as an atypical antipsychotic to reduce anxiety and agitation. Combined with
cognitive rehabilitation and cognitive stimulation.
Đầu tiên, bạn cần phải khám lâm sàng. Sau đó, tôi sẽ kê cho bạn một loại thuốc ức chế
cholinesterase cũng như thuốc chống loạn thần không điển hình để giảm lo lắng và kích
động. Kết hợp với phục hồi chức năng nhận thức và kích thích nhận thức.
D: I will schedule a follow-up appointment for you three weeks later.
Tôi sẽ sắp xếp một cuộc hẹn tái khám cho bạn ba tuần sau.
P: oh thank you very much, doctor.

CẢNH 2:
PRO: Good morning everyone!!!
S1, S2, S3, S4, S5, S6: Good morning, professor!!! ( inquire, interact, freestyle)
PRO: OKAY, Let's start today's discussion. As promised, today we will talk about typical
diseases related to the nervous system. I have a pretty interesting clinical case for us to
discuss, which is Alzheimer's disease. Do you know anything about it?
S1: Yes, professor, I know it is a typical form of dementia. Alzheimer's disease is a brain
disorder that gets worse over time.
S2: That's exactly it!! Alzheimer’s disease is a brain condition that causes a progressive
memory decline, in thinking, learning, and organizing skills. It eventually affects a person’s
ability to carry out basic daily activities.
S3: So it can be said that Alzheimer's disease (AD) is the most common cause of dementia,
right?
PRO: It seems you know quite a lot about this disease. So what is the cause of the disease?
S4: I have read some medical articles about Alzheimer's disease, it says AD is characterized by
changes in the brain that lead to deposits of certain proteins. Alzheimer's disease causes the
brain to shrink and brain cells to eventually die.
PRO: How about more specifically?
S5: Researchers trying to understand the cause of Alzheimer's disease are focused on the role
of two proteins including Beta-amyloid and Tau proteins.
S6: oh, they sound quite familiar. Beta-amyloid appears to have a toxic effect on neurons and
disrupt communication between brain cells. Tau proteins can disrupt transport systems and
cause cell damage.
S1: Does the patient have any special symptoms, professor?
PRO: Patient forgets where to put things, sleep is also disturbed, Mood or personality also
changes, and disoriented and easily confused. Besides the causes, do you know about the risk
factors for Alzheimer's disease?
S2: Sir, there are two risk factors for Alzheimer's disease including Environmental risk factors
and Genetic risk factors.
S3: That's my answer too. More specifically, environmental risk factors include Sedentary
Lifestyle, High Cholesterol, High Blood Pressure, and Diabetes. And common genetic factors
such as Down Syndrome, Mutations in Presenilin Genes, and Inheritance of the APO E4 Allele.
PRO: The information you shared is very accurate. This disease will get worse over time and is
divided into several stages. Do you know about the stages of Alzheimer's disease?
S4: Yes, professor, Alzheimer's disease progresses in three stages: Early Stage, Middle Stage,
and Late Stage.
S5: What seems to be missing is a pre-clinical stage of Alzheimer's disease when there are
changes in the brain but no symptoms are noted.
S6: So, the more the patient progresses to the later stages, the more severe the symptoms will
be, right professor?
PRO: This is correct!
S1: Starting from the middle stage, patients need a caregiver. Because the more severe the
disease, the less control the patient has in his or her behavior.
S2: As far as I know, There's no cure for Alzheimer’s, but there are treatments that may change
disease progression. What are those methods, professor?
PRO: This is a good question. There are two methods: drug and non-drug options that may help
treat symptoms.
S3: I think cognitive training methods for dementia can be applied in this case.
S4: I think so, too. Cognitive training, cognitive rehabilitation, and cognitive stimulation a
coordinated training methods of great value in the field of cognitive training.
S5: Therefore, combining medication and cognitive improvement methods can help increase
treatment effectiveness.
S6: I have just found some drug names used to treat Alzheimer's disease.
S1: That sounds so interesting, please say it quickly!!!
S2: I guess there will be Donepezil and Galantamine.
S6: That's right, some common medications include Brexpiprazole, Donepezil, Galantamine,
and Memantine.
S3: oh, so maybe Memantine is for severe stages, right?
S6: That's exactly right!!!
S4: I know about the mechanism of this medicine. Memantine Treats symptoms of moderate to
severe Alzheimer’s by blocking the toxic effects associated with excess glutamate and regulates
glutamate activation.
S5: Wow, this is such a complicated disease!!! :((((((
S1: I think the reason Alzheimer's is so complicated is because each stage of the disease is
different.
S2: We will need to create an appropriate treatment regimen for each stage.
S3: Of course, I think this is extremely necessary.
PRO: You did very well today. And it seems that you have a good understanding of Alzheimer's
disease, so we will end here. Do you have any questions about this disease?
S4: Can we request a patient's medical records for reference?
PRO: Of course it's okay. I will send it to you as soon as I finish it.
—---------END!!!!!!!!!!!!!!!!!!!!!!!!!!!!-----------

CẢNH 3:
P: Hello doctor, I have an appointment after three weeks of treatment.
Xin chào bác sĩ, tôi đến hẹn sau ba tuần điều trị.
D: Hello, tBN. How do you feel about your health?
Bạn cảm thấy sức khoẻ như thế nào rồi?
P: Things seem worse. I started having aphasia and speech problems. Sometimes I even
hallucinate.
Mọi chuyện có vẻ tệ hơn. Tôi bắt đầu mắc chứng mất ngôn ngữ và vấn đề về giọng nói.
Đôi khi tôi còn bị ảo giác.
D: I'll order you an MRI, to look for other abnormalities in the brain.
Tôi sẽ yêu cầu bạn chụp MRI để tìm những bất thường khác trong não.
P: Okay, I'll do it now.
Được rồi, tôi sẽ làm ngay.
_____________three hundred years________________
P: I have completed the test, doctor.( hành động đưa ảnh MRI)
Tôi đã hoàn thành bài kiểm tra rồi, bác sĩ.
D: um, from the picture it seems like the disease has taken a turn for the worse. I will prescribe
a higher dose of Memantine for you. Let's see if it gets better.
ừm, nhìn từ bức ảnh thì có vẻ như bệnh đã chuyển biến nặng hơn. Tôi sẽ kê đơn thuốc
memantine liều cao hơn cho bạn. Hãy xem liệu nó có tốt hơn không. (ảnh MRI)
D: And it is very important for caregivers of Alzheimer's patients to: encourage the patient's
independence, while still ensuring their safety; You can patiently eat with them and avoid noise
because sick people often find it difficult to eat and drink.
Và điều rất quan trọng đối với những người chăm sóc bệnh nhân Alzheimer là: khuyến
khích sự độc lập của bệnh nhân nhưng vẫn đảm bảo an toàn cho họ; Bạn có thể kiên
nhẫn ăn cùng họ và tránh ồn ào vì người bệnh thường khó ăn uống.
Người nhà:(gật gật đầu) oke,thanks doctor, I will do that.
P: Thank you doctor!!!
END
Diseases related to the nervous system are increasing in Vietnam, but what is worrying
is that most patients do not have enough knowledge about the disease and are
subjective about the symptoms. Alzheimer's disease occurs due to the brain aging
process over time and age. However, the disease can come early or late, the severity or
severity depends on our lifestyle and activities. Therefore, live a healthy, scientific life
and exercise regularly.