A 67 year old man with HTN, Type 2 DM , HTN states that he began to have pain in

Question

A 67 year old man with HTN, Type 2 DM , HTN states that he began to have pain in his left calf when climbing the 10 stairs to his apartment. This pain is relieved by sitting for approximately 2 minutes, then he is able to resume his activities. Smoked 1ppd for 50 years. He denies CP, Cough , DOE or swelling of ankles. You interpret that this patient most likely experiences insufficiency? What contribution does history have, What physical exam techniques would you use to assess these clients. Describe your expected physical exam findings, Discuss the pathophysiology associated with this case. A 67 year old man with HTN, Type 2 DM , HTN states that he began to have pain in his left calf when climbing the 10 stairs to his apartment. This pain is relieved by sitting for approximately 2 minutes, then he is able to resume his activities. Smoked 1ppd for 50 years. He denies CP, Cough , DOE or swelling of ankles. You interpret that this patient most likely experiences insufficiency? What contribution does history have, What physical exam techniques would you use to assess these clients. Describe your expected physical exam findings, Discuss the pathophysiology associated with this case.

Explanation / Answer

Elevated blood pressure,history of tobacco smoking and diabetes mellitus are the leading causes for higher body dysfunctioning,thrombosis,artherosclerosis ,defects in endothelial function and inflammation.But according to the patients history given in pain management,he did not show any signs of such incidents except for pain in left calf.But in near future he might experience all these insufficiencies .Active smoking might increase the risk of renovascular,malignant and masked hypertension.The physical exam techniques that i would assess to this patient would be EGFR (glomerular filtration rate ) to know any kidney complications,doppler test for any vascular diseases due to hypertension and smoking,to know the history of ketoacidosis,active cancer and chronic liver problems,laboratory evaluation such as determination of creatinine,glycated hemoglobin,total cholestrol,triglycerides.

According to the test recommended,chances of abnormal doppler test might be observed as the result of active smoking and hypertension and rest all of the test like HDL,LDL and hemoglobin obviously shows abnormal results but upto what extent to be known which helps in increase and decrease of the medication.

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