A patient comes into your medical office and your task is to give an assessment

Question

A patient comes into your medical office and your task is to give an assessment and a possible diagnosis. Calculate her BMI, give a risk assessment for cardiovascular disease, and give her recommendations on what she can do to improve her health. Patients’ characteristics: Female, age 55

Body weight: 185 lbs

Height: 5 feet 4 inches

Fasting glucose: 130 mg/dL

Triglycerides: 190 mg/dL

Blood pressure: 150/90 mmHg

HDL-C: 45 mg/dL

Medical history: no pregnancies, father died of a heart attack at age 50

Other: smoker for 15 years, sedentary, recently unemployed and looking for job, patient reportedly eats <5 servings of fruits and vegetables per week, eats at McDonald’s 3 times/wk.

Observations: patient had dyspnea and had to stop the exercise stress test early because of this.

Lung function tests reveal a FEV1 of 40%.

Explanation / Answer

Body weight = 185 pounds = 83.91 Kg

Heght = 5 feet 4 inches = 164.6 cm

BMI = 31 which is above 22.5

This indicates that the patient is obese.

The normal fasting glucose level is 70-99 mg/dL, this means glucose level of the patient is also high.

Triglycerides are a type of fat found in the blood. A triglyceride level of 150 mg/dL or higher (or being on medicine to treat high triglycerides) is a metabolic risk factor.

HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 45 mg/dL is low and is considered a risk factor because it increases your risk of developing heart disease. HDL levels of 60 mg/dL or more help to lower your risk for heart disease.

The blood pressure higher than 130/85 mmHg is regarded as hypertension.

All the above parameters indicate that the patient is at high risk of developing cardiovascular disease. Carbohydrate-rich and fat-rich died should be stopped immediately. The patient is also advised to do a regular exercise.

Other patient

FEV1 is a marker for the degree of obstruction due to asthma: FEV1 greater 80% of predicted= normal. FEV1 60% to 79% of predicted = Mild obstruction. FEV1 40% to 59% of predicted = Moderate obstruction.

Smoking should be stopped immediately, fruit serving should be increased and eats at McDonald's should be decreased to 1time/wk or stopped

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