Question

Note this are medical/Pharmacy questions!!!

1. A 54-year-old woman presents in a hospital with complaint of chest pain associated with forceful activities. The pain is dull but poorly localized and disappears few minutes of rest. No history of smoking but there is a positive history of hyperlipidemia. and admits that she has not been following the recommended diet. There was family history of heart attacks and cardiac diseases. Physical examination reveal blood pressure of 150/95 mm Hg, and heart rate of 80 bpm and nothing else is contributory; an electrocardiogram is normal except for slight left ventricular hypertrophy.

a. what is your working diagnosis?

b. what are drug (s) of choice for the treatment? why

c. what counselling will you give to the patient

d. write a summary on your diagnosis

2. A 48-year-old known hypertensive man is brought to the hospital with 3day history of fever and a productive cough. There is positive history of headache and is increasingly confused. Drug history include hydrochlorothiazide and lisinopril for hypertension. Patient is allergic to amoxicillin. On examination, the temperature was 38.7°C [101.7°F]), blood pressure 90/54 mmHg, respiratory rate 36/min, and pulse 110/min. there was no signs of meningeal irritation but oriented only to person. A chest x-ray shows a left lower lung consolidation. A CT scan is not contributory

a. what is your working diagnosis and 2 differential diagnoses?

b. what’s drug (s) of choice? Why

c. what counselling wil you provide to the patient?

d. write a summary on your diagnosis

Answer 1

1

A. The possibile diagnosis is Angina Pectoris

B. Drug of choice includes:

Sublingual nitroglycerin can be used for acute relief of angina and prophylactically before activities that may precipitate angina. The action of this drug is vasodilation.

Calcium channel antagonists: prevent coronary artery spasm and increase the blood flow to the myocardium.

Beta blockers:

C.she has a strong family history of cardiac problems, so advise the patient that it is essential to control the hypertension and hyperlipidemia.

Follow the recommended diet and nutritional councelling.

Eat non fat or low fat dairy products such as skim milk, low fat yogurt etc.

Patient is hypertensive, so avoid high sodium diet.

Importance of regular medical checkup.

Importance of regular medication regimen.

Avoid Sternos activities.Have rest in between the activities.

D. In Angina Pectoris, the chestpain is associated with activities and relieved by rest or sublingual nitroglycerin.patient may have normal or elevated blood pressure and cholesterol levels.here patient is hypertensive and has hyperlipidemia.pulse rate can be normal or rapid. ECG can be normal when recorded in between the attacks.