VISE NR 661
Hypertension-Presentation - ANS: Most are not symptomatic, Occipital Headaches, headache on
awakening in am, blurry vision,
Diagnostic studies for Hypertension - ANS: EKG,
fasting lipid profile,
fasting blood glucose,
CBC,
CMP, and
urinalysis.
Diagnosis: > 140/90 mm Hg start on B/P medication.
Non-pharmacologic Management for Hypertension - ANS: o Lifestyle modifications: diet and exercise 30
minutes aerobic exercise 5 days per week.
o Limit alcohol
o stop smoking
o stress management
Pharmacologic Management for Hypertension - ANS: o hydrochlorothiazide (HCTZ) 25 mg/day
o ALTERNATIVE Amlodipine besylate 5 mg /day. I
o lisinopril 10mg/day complicated HTN
Follow up for Hypertension - ANS: Referral:
o 2-4weeks
o Cardiology if EKG is normal
,Hyperlipidemia Presentation - ANS: Xanthomata (lipid deposits around the eyes)
o Corneal Arcus prior to age 50 years
Diagnostics for Hyperlipidemia - ANS: o lipid profile
o Glucose,
o UA and creatinine (for detection of nephrotic syndrome which can induce
dyslipidemia),
o TSH (for detection of hypothyroidism)
o CMP
Diagnosis: Pt with LDL >= 190mg/dL
Non-pharmacologic Management for Hyperlipidemia - ANS: o Lifestyle Modification; diet and exercise.
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Pharmacologic Management for Hyperlipidemia - ANS: • Atorvastatin 10mg once a day
• Alternative Welchol 625 mg tab daily once a day.
for LDL .>190
Diabetes type 2 Presentation: - ANS: •Polydipsia, Polyuria, Polyphagia,
• agitation,
• nervousness,
• obesity,
• fatigue
, • blurry vision
Diagnostics for Diabetes type 2: - ANS: EKG,
CBC,
CMP,
LIPIDS< Microalbuminuria,
TSH,
Diagnostic criteria for Diabetes type 2 - ANS: A1C Diagnosis: Hgb A1C >or equal to 6.5% or Fasting
glucose>126mg/dl and confirmed on a different day
Non-pharmacologic Management for Diabetes Type 2 - ANS: • Monitor Blood glucose at home and diary
•Lifestyle modification: diet and Exercise
• avoid alcohol
• avoid smoking
---------------------------------
Pharmacologic Management for Diabetes Type 2 - ANS: • Metformin 500mg twice a day. (first line)
• Actos 15 mg daily
• Levemir 10 units once a day
Referral for Diabetes Type 2 - ANS: • Ophthalmologist
• Diabetic educator
• Podiatry
Back pain Presentation: - ANS: back pain complaint.
Hypertension-Presentation - ANS: Most are not symptomatic, Occipital Headaches, headache on
awakening in am, blurry vision,
Diagnostic studies for Hypertension - ANS: EKG,
fasting lipid profile,
fasting blood glucose,
CBC,
CMP, and
urinalysis.
Diagnosis: > 140/90 mm Hg start on B/P medication.
Non-pharmacologic Management for Hypertension - ANS: o Lifestyle modifications: diet and exercise 30
minutes aerobic exercise 5 days per week.
o Limit alcohol
o stop smoking
o stress management
Pharmacologic Management for Hypertension - ANS: o hydrochlorothiazide (HCTZ) 25 mg/day
o ALTERNATIVE Amlodipine besylate 5 mg /day. I
o lisinopril 10mg/day complicated HTN
Follow up for Hypertension - ANS: Referral:
o 2-4weeks
o Cardiology if EKG is normal
,Hyperlipidemia Presentation - ANS: Xanthomata (lipid deposits around the eyes)
o Corneal Arcus prior to age 50 years
Diagnostics for Hyperlipidemia - ANS: o lipid profile
o Glucose,
o UA and creatinine (for detection of nephrotic syndrome which can induce
dyslipidemia),
o TSH (for detection of hypothyroidism)
o CMP
Diagnosis: Pt with LDL >= 190mg/dL
Non-pharmacologic Management for Hyperlipidemia - ANS: o Lifestyle Modification; diet and exercise.
-----------------------------------------
Pharmacologic Management for Hyperlipidemia - ANS: • Atorvastatin 10mg once a day
• Alternative Welchol 625 mg tab daily once a day.
for LDL .>190
Diabetes type 2 Presentation: - ANS: •Polydipsia, Polyuria, Polyphagia,
• agitation,
• nervousness,
• obesity,
• fatigue
, • blurry vision
Diagnostics for Diabetes type 2: - ANS: EKG,
CBC,
CMP,
LIPIDS< Microalbuminuria,
TSH,
Diagnostic criteria for Diabetes type 2 - ANS: A1C Diagnosis: Hgb A1C >or equal to 6.5% or Fasting
glucose>126mg/dl and confirmed on a different day
Non-pharmacologic Management for Diabetes Type 2 - ANS: • Monitor Blood glucose at home and diary
•Lifestyle modification: diet and Exercise
• avoid alcohol
• avoid smoking
---------------------------------
Pharmacologic Management for Diabetes Type 2 - ANS: • Metformin 500mg twice a day. (first line)
• Actos 15 mg daily
• Levemir 10 units once a day
Referral for Diabetes Type 2 - ANS: • Ophthalmologist
• Diabetic educator
• Podiatry
Back pain Presentation: - ANS: back pain complaint.
