Question

Question: Do a reflection to possible links with these pathologies, with the medical history and with nutrition. It is necessary to link/to make assumptions with the disease that the patient has, and his symptoms with the medical history of the patient, such as relatives who died from diabetes and myocardial infarction, or as renal failure and diabetes. Hypertension and high cholesterol, hypertension and diabetes, angina and atherosclerosis, angina and oxygenation of heart cells, why he had a blockage at the level of the coronary artery. And also make connections of all the symptoms and diseases diagnosed with nutrition, for example, high cholesterol and consumption of meats, cholesterol and saturated and unsaturated molecules, cholesterol and liver (is the liver overloaded and why?), or why did he take the CBC test, what is the link of that (CBC) with diabetes or cholesterol?

The patient's history for update purposes

Patient A age 70. He is obese and 100% sedentary. He needs to do physical exercises, to lose weight, to decrease stress and to eat better (but he does not do that). He has diabetes: 25 years ago, he was diagnosed with diabetes type 2 and he has to take insulin.

Diet: He eats meat 3 times a day and does not eat dietary fiber.

Emotional: He is stressed and anxious, and works hard.

Parents: The mother and father died young because of complications of diabetes. Father: died at age 53 of myocardial infarction.

Symptoms now: shortness of breath, chest pain due to physical exertion (angina).

Has high blood pressure: 140/90. Never had hypertension before. His doctor prescribed for hypertension: Vasotec (enalapril).

He must take the following exams:

FSC: red blood cells, white blood cells and platelets

Lipid profile

Creatinine test

Uremia test (urine in the blood)

Electrolytes test (usually sodium or potassium or an acid-base imbalance)

Clearance of creatinine test

HbA1c test (also called glycated hemoglobin test, and glycohemoglobin)

Stress ECG test

Urine analysis

3 weeks later, the results:

Clearance of creatinine test show to us the GFR (Glomerular Filtration Rate) results:
GFR 55mL/min (normal: 90-125mL/min)

Lipid profile: low level HDL, high level LDL

Plasma creatinine level (creatinine test): 150 mmol/L (normal: 50-110 umol/L)

Uremia test : 8 mmol/L (N : 3 - 6,5 mmol/L)

Urine analysis: 120 mg/L of proteins (normal: < 80 mg/L)

Stress ECG test: Anomalies related to unstable angina

Doctor's conclusion: chronic renal insufficiency (CRI), unstable angina. Needs to do an emergency angiography.

Angiography test results: several atheroma plaques in the coronary arteries. He had to put four stents during the procedure.

He had to take these medicaments:

Clopidogrel (Plavix), Aspirine (acide salicylique, for 1 year), and Crestor (is a statine). And also, the insulin and Vasotec (énalapril).

Question C: Do a reflection to possible links with these pathologies, with the medical history and with nutrition.

Answer 1

1.He had a blockage at the level of coronary artery as he has the positive causative factors for getting the block like family history of diabetes, high cholesterol, obesity, age factor, high stress, high blood pressure and a sedentary life style which are considered to be the risk factor for geeting the coronary artery block. it occurs when the major blood vessel supplying the nutrients, blood oxygen to the heart is diseased or damaged.

2. Liver is the major site where the endogenous synthesis of cholesterol occurs. the liver transport the needed cholesterol in form of LDL to the cells of the body. if there is a deficit, liver produces excess and in case of excess cholesterol, liver may send the excess back down to the gut with the help of HDL. If there is excess LDL and there is not adequate HDL to send back the excess LDL, the excess cholesterol starts building up on the walls of arteries.

3. Interlink between CBC and Diabetes and Cholesterol.

WBC may indicate the infection, inflammation, stress or tissue damage.

Platelets can give information on risk for excessive bleeding or the risk of forming a clot in case of conditions like atherosclerois

Differential count helps to assess the body's condition to combat infection

4.Do a reflection to possible links with these pathologies, with the medical history and with nutrition.

Yes. Patient is having the risk of getting all the causative factor for coronary artery block as mentioned above. He also eats meat 3 times a day with no dietary fiber.