Question

Mary is 59 years old with a history of stage 1 HTN, prediabetes and hyperlipidemia type 2. Her younger brother just had a heart attack at age 40 and her older brother died 6 months age with a stroke. She has not been to your office in 3 years or any other HCP. Her laboratory values are: HbA1c 6.8%, total cholesterol 320 mg, LDL 105, HDL 25 mg

1.Identify her risk factors and severity of illness

2. DESIGN A TREATMENT PLAN with rationales

Answer 1

Risk Factor -

1. Stage 1 Hypertension

2. Prediabetes

3. Hyperlipidaemia type 2

4.Family history of heart attack and stroke

As per laboratory results her HbA1C and Cholesterol levels are high and with above mentioned risk factors Mary is more prone for cardivascular diseases like stroke and heart attack than normal population.

Treatment Plan

1. For Diabetes - Avoid refined sugar and take a low carbohydrate diet, repeat HBA1C level and Fasting blood sugar after 3 months, if still not controlled start on medication for diabetes.

2. for stage I hypertension she has to be started on antihypertensive medications and regular monitoring of blood pressure

3. For hyperlipidaemia - Avoid saturated and transfat in diet, consume a low fat diet, repeat level after 3 months if still high start on medication

4. Excercise - Aerobic excercise, like walking, running, swiming should be done atleast for 30 min

5. Diet -- Low carbohydrate, low fat, high protein and high fibre diet