Question

A patient comes to your clinic with the following health history. (10 points)

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Dx: Metabolic Syndrome

Age: 68 years old        Gender: Female          Race: Caucasian               BMI: 24 kg/m²       

SBP: 155 mmHg      DBP: 77 mmHg      TG: 158 mg/dl     Blood glucose: 140 mg/dl       HDL: 38 mg/dl

Waist Circumference: 33 inches     bodyweight: 145 pounds       Total cholesterol: 210 mg/dl

LDL: 140 mg/dl

Meds: Atenolol, Zocor

Dr. Goal: improve the metabolic panel to reduce metabolic syndrome with exercise.

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Part 1: Of the listed criteria, what are the values that classify the patient as having metabolic syndrome?

Part 2: With the exception of blood glucose (we haven’t talked about that yet), list the potential reductions that exercise could provide for all of the metabolic measures.

Part 3: Using the FITT principle, what would you suggest the exercise plan look like? What comorbid condition poses the biggest risk? What might you need to consider with the FITT plan?

*All Information that was given*

Answer 1

Part 1 -

LDL - 140mg/dl ( normal 60-110 mg/dl ) raised

Raised total cholesterol (>200)

Systolic BP raised.  

Part 2 -

Exercise can reduce systolic BP and waist circumference too . It can also increase HDL which is good for health and can lower triglycerides level .

It has not much impact on lowering LDL but weight loss and dietary habits can reduce LDL and exercise help in lowering weight.

Part 3 -

FITT plan stands in term of exercise which provide physical fitness through daily workouts including following concepts -

Frequency

Intensity

Time

Type

In this patient , exercise plan is more diverted towards cardio workout for 5 days in a week and moderate intensity with strength workout in alternate days .

Exercise plan :

Frequency .- 5 days a week cardio workout

Intesity - can be measured by heart rate , talk test , monitoring of heart condition .

Time - it can be 20 min for beginner and 20-30 min later in with high intensity

Type - for cardio work out it can be running , cycling , swimmimg .

Co-morbid conditions are atherosclerosis , heart failure , left ventricular failure , diabetes , hypertension , hepatic diseases due to increased fatty acids .

For FITT , we need to consider for how much duration , intesity , frequency and type of exercise planned for physical fitness which improve health status along with this proper dietary habits including low salt intake , low saturated fats consumption . More fruits and juices and adequate sleep with physical exercise is needed .