A s s i g n m e n t 1 0 . 2 : S h a d o w H e a l t h -
F o c u s e d E x a m : H y p e r t e n s i o n a n d T y p e 2
D i a b e t e s
P a tie n t: A r u n P a te l
D O B : 1 0 /0 6 /1 9 8 1
H e ig h t: 5 ’9
W e ig h t: 2 3 3 lb s
A lle r g y : N K D A
D ia g n o s is : H y p e rte n s io n (D ia g n o s e d 1 y e a r a g o ) & D ia b e te s M e llitu s T y p e 2 (D ia g n o s e d 5
y e a rs a g o )
S c e n a rio : A ru n P a te l is a 3 8 -y e a r-o ld In d ia n A m e ric a n m a le w h o c a m e to th e c lin ic to d a y fo r a fo llo w -u p
a p p o in tm e n t in re g a rd s to h is tre a tm e n t fo r h y p e rte n s io n a n d d ia b e te s ty p e 2 .
H o m e m e d ic a tio n s :
H y d ro c h lo ro th ia z id e 5 0 m g P O d a ily (S ta rte d 1 y e a r a g o )
M e tfo rm in 8 5 0 m g P O 3 x d a y w ith m e a ls (S ta rte d 5 y e a rs a g o )
E s c ita lo p ra m 2 0 m g P O d a ily (S ta rte d 1 3 y e a rs a g o )
V ita ls : T e m p 3 7 C (T e m p o ra l), B lo o d p re s s u re 1 4 6 /9 4 (A u to m a tic ), H e a rt ra te 7 5 (N S R ), O 2 s a t
9 8 % (ro o m a ir), R e s p ira to ry ra te 2 3 .
A s s e s s m e n t: M r. P a te l c a m e to th e c lin ic fo r a fo llo w -u p a p p o in tm e n t fo r th e tre a tm e n t o f h is h yp e rte n s io n a n d
typ e 2 d ia b e te s . H e s ta te s h e h a s b e e n g ro w in g m o re w o rrie d a n d a n x io u s a b o u t life . H e is c u rre n tly a s tu d e n t
a n d te a c h e s film a t th e lo c a l u n ive rs ity w h ic h is h is m a in s o u rc e o f in c o m e . H e d o e s h a v e lim ite d fu n d s a lth o u g h
h e d o e s h a ve h e a lth in s u ra n c e th ro u g h h is e m p lo ye r a n d c a n a ffo rd p re s c rip tio n m e d ic a tio n s a t a re a s o n a b le to
in e x p e n s ive c o s t. T h e p a tie n t s ta te s h e w a s d ia g n o s e d w ith g e n e ra liz e d a n x ie ty d is o rd e r 1 3 ye a rs a g o a n d h a s b e e n o n E s c ita lo p ra m e ve r s in c e . H e d e n ie s a n y d e p re s s ive s ym p to m s b u t d o e s h a ve p a n ic a tta c k s o n
F o c u s e d E x a m : H y p e r t e n s i o n a n d T y p e 2
D i a b e t e s
P a tie n t: A r u n P a te l
D O B : 1 0 /0 6 /1 9 8 1
H e ig h t: 5 ’9
W e ig h t: 2 3 3 lb s
A lle r g y : N K D A
D ia g n o s is : H y p e rte n s io n (D ia g n o s e d 1 y e a r a g o ) & D ia b e te s M e llitu s T y p e 2 (D ia g n o s e d 5
y e a rs a g o )
S c e n a rio : A ru n P a te l is a 3 8 -y e a r-o ld In d ia n A m e ric a n m a le w h o c a m e to th e c lin ic to d a y fo r a fo llo w -u p
a p p o in tm e n t in re g a rd s to h is tre a tm e n t fo r h y p e rte n s io n a n d d ia b e te s ty p e 2 .
H o m e m e d ic a tio n s :
H y d ro c h lo ro th ia z id e 5 0 m g P O d a ily (S ta rte d 1 y e a r a g o )
M e tfo rm in 8 5 0 m g P O 3 x d a y w ith m e a ls (S ta rte d 5 y e a rs a g o )
E s c ita lo p ra m 2 0 m g P O d a ily (S ta rte d 1 3 y e a rs a g o )
V ita ls : T e m p 3 7 C (T e m p o ra l), B lo o d p re s s u re 1 4 6 /9 4 (A u to m a tic ), H e a rt ra te 7 5 (N S R ), O 2 s a t
9 8 % (ro o m a ir), R e s p ira to ry ra te 2 3 .
A s s e s s m e n t: M r. P a te l c a m e to th e c lin ic fo r a fo llo w -u p a p p o in tm e n t fo r th e tre a tm e n t o f h is h yp e rte n s io n a n d
typ e 2 d ia b e te s . H e s ta te s h e h a s b e e n g ro w in g m o re w o rrie d a n d a n x io u s a b o u t life . H e is c u rre n tly a s tu d e n t
a n d te a c h e s film a t th e lo c a l u n ive rs ity w h ic h is h is m a in s o u rc e o f in c o m e . H e d o e s h a v e lim ite d fu n d s a lth o u g h
h e d o e s h a ve h e a lth in s u ra n c e th ro u g h h is e m p lo ye r a n d c a n a ffo rd p re s c rip tio n m e d ic a tio n s a t a re a s o n a b le to
in e x p e n s ive c o s t. T h e p a tie n t s ta te s h e w a s d ia g n o s e d w ith g e n e ra liz e d a n x ie ty d is o rd e r 1 3 ye a rs a g o a n d h a s b e e n o n E s c ita lo p ra m e ve r s in c e . H e d e n ie s a n y d e p re s s ive s ym p to m s b u t d o e s h a ve p a n ic a tta c k s o n
