Case Study M.K. is a 45-year-old female, measuring 5\'\'5\" and weighs 225 lbs.
ID: 91668 • Letter: C
Question
Case Study M.K. is a 45-year-old female, measuring 5''5" and weighs 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 increase 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: Vitals BP 158/98 mm Hg CBC Hematocrit 57% Glycosylated hemoglobin (HbA1c) 7.3 % Arterial Blood Gas Assessment PaCO2 52 mm Hg PaO2 48 mm Hg Lipid Panel Cholesterol 242 mg/dL HDL 32 mg/dL LDL 173 mg/dL Triglycerides 1000 mg/dL
1. 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?
2. Which type of heart failure would you suspect with M.K.? Explain the pathogenesis of how this type of heart failure develops.
3. According to the B.P. value, what stage of hypertension is M. K. experiencing? Explain the rationale for her current medications for her hypertension. Also, discuss the impact of this disease in the U.S. population.
4. 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?
5. Interpret the lab value for HbA1c and explain the rationale for this value in relation to normal/abnormal body function
Explanation / Answer
1 Studying the MK case history and symptoms we can say that MK is suffering form smoking induced chronic bronchitis we can say this by seeing her past history of smoking Cigarette smoking is the most common cause of chronic bronchitis This causes the cells to release multiple types of cytokines, which are small signaling proteins that cause the airway lining to thicken and airways to become inflamed.Urinary tract infection may also caused by secondary infection causing increased urination during night
The persistent airway inflammation caused by cigarette smoke. Cigarette smoke also induces a cascading effect that results in certain cells producing more mucus than normal.
The treatment can be started with quitting of smoking proper counseling and therapy can given to quit smoking, avoid dust places and away from air pollution. Cough caused by smoking can be treated by taking mild cough syrups oxygen therapy can be taken to clear air passage. Antibiotics can be taken for secondary infections.
2 Severe smoking induced bronchitis cause heart failure in your heart’s lower right chamber, or ventricle. This is a condition called right-sided heart failure or cor pulmonale.
Right-sided heart failure causes fluid like sputum to build up in your body, such as in your legs and belly area. Heart failure mainly seen due to congestion of bronchi by sputum making difficult to breathe leading to high blood pressure and leads to heart failure
3 Hypertension is diagnosed when your systolic pressure is 140 mm Hg or above or when your diastolic pressure is 90 or above. In people who have diabetes or kidney disease, hypertension is diagnosed when blood pressure is 130/80 mm Hg or higher. The higher your blood pressure is, the greater your risk of developing blood pressure-related complications such as heart disease, heart failure, stroke, or kidney failure.
The first stage of hypertension is called stage 1 hypertension. The systolic pressure is 140 to 159 mm Hg or your diastolic pressure is 90 to 99 mm Hg. The next stage of hypertension, stage 2 hypertension, is diagnosed when your systolic pressure is 160 mm Hg or higher or your diastolic pressure is 100 mm Hg or higher and from MK BP value of 158 mm Hg we can say that she is experience second stage hypertension 2.
Smoking history starting at age 20 years. By age 60 years, this person will have inhaled the smoke from approximately 290,000 cigarettes and will bear a substantial risk for chronic obstructive pulmonary disease and is US smoking is common from younger age which risk many of the individuals to disease of smoking induced bronchitis proper awareness should be started against smoking and its ill effects.
4 Cholesterol is a form of fat we need and lipid is stored as cholesterol. It helps make the outer membranes of our bodies cells stable High total cholesterol could raise chances of heart failure.
Cholesterol blocks arteries in a process called atherosclerosis. Narrowed arteries in your heart can then develop sudden blood clots, causing heart attacks.
5 The normal range for level for hemoglobin A1c is less than 6% HbA1c levels are reflective of blood glucose levels over the past six to eight weeks and do not reflect daily ups and downs of blood glucose High HbA1c levels indicate poorer control of diabetes than levels in the normal range and any deviation from normal HbAc indicates that glucose level in body is abnormal and may lead to heart failure due to increased glucose carrying capacity of blood vessels.