NR667 VISE CALL 2022

NR667 VISE CALL 2022 1. Hypertension Presentation: Most are not symptomatic, Occipital Headaches, headache on awakening in am, burry vision, Diagnostic studies: EKG, fasting lipid profile, fasting blood glucose, CBC, CMP, and urinalysis. Diagnosis: > 140/90 mm Hg start on B/P medication. Non-pharmacologic Management:  Lifestyle modifications: diet and exercise 30 minutes aerobic exercise 5 days per week.  Limit alcohol  stop smoking  stress management. Pharmacologic Management:  hydrochlorothiazide (HCTZ) 25 mg/day  ALTERNATIVE Amlodipine besylate 5 mg /day. I  lisinopril 10mg/day complicated HTN Follow up:  2-4weeks Referral:  Cardiology if EKG is normal 2. Hyperlipidemia Presentation:  Xanthomata (lipid deposits around the eyes)  Corneal Arcus prior to age 50 years Diagnostics:  lipid profile  Glucose,  UA and creatinine (for detection of nephrotic syndrome which can induce dyslipidemia),  TSH (for detection of hypothyroidism)  CMP Diagnosis: Pt with LDL >= 190mg/dL Non-pharmacologic Management:  Lifestyle Modification; diet and exercise. Pharmacologic Management:  Atorvastatin 10mg once a day  Alternative Welchol 625 mg tab daily once a day. Follow up: 6-8 Refer: Nutritionist 3. Diabetes type 2 Presentation:  Polydipsia, Polyuria, Polyphagia,  agitation,  nervousness,  obesity,  fatigue  blurry vision Diagnostics: EKG, CBC, CMP, LIPIDS< Microalbuminuria, TSH, A1C Diagnosis:  Hgb A1C >or equal to 6.5%  Fasting glucose>126mg/dl and confirmed on a different day Non-pharmacologic Management:  Monitor Blood glucose at home and diary  Lifestyle modification: diet and Exercise  avoid alcohol  avoid smoking Pharmacologic Management:  Metformin 500mg twice a day.  Actos 15 mg daily  Levemir 10 units once a day Follow up:  2-4 weeks Referral:  Ophthalmologist