pbl metabolic syndrome 2.docx - Part 1 Medical notes written by a panel doctor for Kenneth 46 years old who presented for medical examination prior to

pbl metabolic syndrome 2.docx - Part 1 Medical notes...

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Part 1 Medical notes written by a panel doctor for Kenneth, 46 years old, who presented for medical examination prior to taking up a new job. Fasting lipids – TC 5.3 (high), LDL 3.4 (high), HDL – 1.0, TG - 1.5 (high) M / I / 46 (109 kg, 173cm) MHx – No Hx illness or injury DHx – NKDA no known drug allergies , Nil except PCM occasionally for backaches and pain SHx - Married, 2 children - New job – salesman – travels 3 to 4 times a week. Previously also salesman - Denies tobacco use - Alcohol – moderate FHx - Father – Passed away MVA motor vehicle accident. - Mother – 2 MI episodes before passed away at 64 y - Older brother – DM, Hpt, ‘overweight’ OE - BP 155/95 mmHg, 145/90mmHg (repeat), HR 88 bpm, RR 16 bpm - Temp 37 C - ECG – SR - Urinalysis – NAD - FBS – 7.2 mmol/L (last week) fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) - Na/K/Cr/Urea – 135 / 4.2 / 98 / 3.9 (normal) - CBC – Normal - Fasting lipids – TC 5.3, LDL 3.4, HDL – 1.0, TG - 1.5 - - Obese, waist circumference ~42” waist should be less than 40 inches around for men, and less than 35 inches for women Hypertension DM ? Metabolic syndrome
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Part 2 At his follow up visit to the doctor a month later, Kenneth reported – making an effort to walk a minimum of 20-30 minutes once a week. being unable to do more exercise or adjust his diet because of frequent travelling as part of his job. only 1 occasion of alcohol use. He repeated to the doctor that he does not smoke. BP readings at this follow up visit were 155/90 and 150/85mmHg. Fasting plasma glucose was 7.5mmol/L. Fasting lipid profile showed minimal change from one month ago. PBL Tasks Session 1 - Identify cues; list & cluster identified problems. - Generate & discuss hypotheses / possible explanations for problems: Activate – clarify – use existing knowledge - Discuss initial case management options – if any known: Activate – clarify – use existing knowledge - List topics to be researched PBL Tasks Session 2 - Present a summary of the case: Draw a mind map or other graphical representation showing known links between problems. - List problems to be addressed - Present and discuss information found to address these problems - Discuss management options & document the management plan: Use the template below as a guide. - Discuss desired or expected outcomes from resolution of the problems Preventive cardiovascular treatment Aspirin therapy may be helpful in the primary prevention of cardiovascular complications, [ 108 ] particularly in patients with at least an intermediate risk of suffering a cardiovascular event (ie, >6% 10 y risk). [ 109 ] [42] Clinical practice guidelines management of dyslipidaemia (5th Edition) [Internet]. Moh.gov.my. 2017 [cited 2020 April 6]. Available from: Table 14. FAQS on Lipids pg 81 Complementary and alternative medicine ginseng, berberine, and bitter gourd , have demonstrated some favorable metabolic effects, but large-scale clinical trials are needed to fully investigate their safety and efficacy.
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  • Winter '19
  • Professor Robert
  • Nutrition, Atherosclerosis, Blood sugar

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