- K. is a 45-year-old female measuring 5’5″ and weighing 225 lbs. M. K. has a history of smoking about 22 years along with a poor diet. She has a history of type II diabetes mellitus along with primary hypertension. M. K. has recently been diagnosed with chronic bronchitis. Her current symptoms include chronic cough, more severe in the mornings with sputum, light-headedness, distended neck veins, excessive peripheral edema, and increased urination at night. Her current medications include Lotensin and Lasix for the hypertension along with Glucophage for the type II diabetes mellitus. The following are lab findings that are pertinent to this case:
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|BP||158/98 mm Hg|
|Glycosylated hemoglobin (HbA1c)||7.3 %|
|Arterial Blood Gas Assessment|
|PaCO₂||52 mm Hg|
|PaO₂||48 mm Hg|
For your signature assignment, compose a 3- to 4-page case analysis, written in APA format with a title page and at least 3 references, with one non-Internet reference. Organize your analysis with headings that thoroughly answer the following prompts. Support your opinions with evidence from your readings and research. Review the rubric for complete grading criteria.
Signature Paper Writing Guideline (only used for Dr. Song’s Patho 370 class)
Answer the following questions
- In your introduction, summarize the case.
- Please use your own words to summarize the patient’s conditions. Simply copy and paste the case or sentences from the case would lead your paper nowhere.
- Please include a brief information about how you will develop the paper.
- What clinical findings correlate with M. K.’s chronic bronchitis? What type of treatment and recommendations would be appropriate for M. K.’s chronic bronchitis?
- Clinical findings should be closely associated with MK’s condition.
- Clinical findings include her symptoms, the signs, and also her risk factors for CB. The pathogenesis of the S/S and the contributions of risk factors to MK’s chronic bronchitis are also expected, briefly though.
- Clinical findings should be related to the patient’s management and treatment.
- Which type of heart failure would you suspect with M. K.? Explain the pathogenesis of how this type of heart failure develops. Include an overview of the disease and it’s effects in the U.S. population.
- The diagnosis of HF should be based on patient’s clinical signs and symptoms.
- Please provide primary cause of her HF, and contributing factors to her heart failure, and most important explain the mechanism of how this type of heart failure would occur in MK. All of the information should relate to the patient in the case, but not general patient in the population. Also, a brief explanation on how this type of HF affects MK on other systems are welcomed.
- Please include the epidemiology of heart failure (the type in MK) in the US population.
- According to the BP value, what stage of hypertension is M. K. experiencing? Explain the rationale for the current medications for her hypertension.
- Please support your conclusion about MK’s hypertension stage with evidence, i.e. briefly review hypertension stages based on international classification. Feel free to discuss the differences between international standard and the one used by American Heart Association.
- Please explain why Lotensin and Lasix are beneficial for MK by exploring drug mechanism of action (MOA) in related to anatomy and physiology. Please be aware, the benefit from those two drugs is not only limited to improve her BP, but also extended to her heart failure condition.
- You are also encouraged to discuss the side effects of those drugs on MK, especially the effects on her other medical conditions such as diabetes.
- According to the lipid panel, what other condition is M. K. at risk for? According to this case study, what other medications should be given and why? What additional findings correlate for both hypertension and type II diabetes mellitus?
- First, you need to explain what the abnormalities of her lipid panel are. Please support your conclusion with normal range value.
- Please explain the pathological conditions that would be resulted in by such abnormality. Briefly explain the pathogenesis of the condition(s) is necessary. Simply provide the name(s) of condition(s) is below expectation.
- Recommended medications need to be reasonable, and a brief explanation how the medication would be beneficial to this particular patient, MK, is expected.
- The additional findings correlated for both HTN and DM are expected to include the risk factors in MK associated with both conditions, and the common S/S presented by both conditions. It is up to you if you want to extend the information to other complications greatly caused by these two conditions.
- Interpret the lab value for HbA1c and explain the rationale for this value in relation to normal/abnormal body function.
- The normal range, diagnostic value, and ideal value in controlled DM patient of HbA1c are expected.
- The definition of HbA1c (also indicating the advantage of HbA1C over serum glucose value) should be included.
- Based on the diagnostic value and ideal value of HbA1c, please explain the meaning MK’s HbA1c value and possible cause(s) of her HbA1c number.
- Provide a conclusion that summarizes your findings and discusses the effects of this disease in the U.S. population.
- Conclusion should summarize the patient’s case and the success and challenges to manage her conditions. Brief epidemiology of DM, HTN, HF, and CB are expected.