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Pure autonomic failure

I have few questions based on the case study ( i will copy and paste it at the end) that I need help with.
I have already figured out that the patient mentioned has Pure Autonomic Failure

1. What is important about when the patient felt lightheaded?
2. If blood pressure is low, how can the autonomic nervous system correct that, normally? Is that happening in this patient? Explain your answer.
3. What toxic molecule would accumulate in the affected cells in this disease (and also in cells in Parkinson's disease)?
4. What prognosis would there be for a patient diagnosed with PAF?

Case 1

Presentation: A 56-year-old retail manager complained of lightheadedness when he awoke in the morning and occasionally throughout the day. He comments that he does not sweat as much as his friends when they play basketball at the local gym.

The patient is 5'11", 178 lbs. His blood pressure is 86/67 and heart rate is 72 bpm. He is afebrile and has no other complaints. A neurological exam did not demonstrate any other deficits. There is no significant family history. The patient is not currently on any medications.

Solution Preview

For a man his size, his resting blood pressure is very low and his heart rate does not compensate for that either. All of his symptoms are suggestive for PAF as you have concluded.

A few articles that will be helpful:
http://www.sciencedirect.com/science/article/pii/B9780444534910000201
http://jnnp.bmj.com/content/76/7/947.full

1. The patient gets lightheaded when getting up in the morning and throughout the day, most likely due to a ...

Solution Summary

The solution discusses pathophysiology of pure autonomic failure and prognosis of disease.

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