case study2

Comprehensive Case Study on COPD, Heart Failure, Hypertension and Diabetes Mellitus

M.K. is a 45 year old female; measuring 5’5” and weighs 225 lbs. M.K. has a history of smoking about 22 years along with a poor diet. She has a history of Type II diabetes mellitus along with primary hypertension. M.K. has recently been diagnosed with chronic bronchitis. Her current symptoms include chronic cough, more severe in the mornings with sputum, light-headedness, distended neck veins, excessive peripheral edema, and increase urination at night. Her current medications include Lotensin and Lasix for the hypertension along with Glucophage for the Type II diabetes mellitus. The following are lab findings that are pertinent to this case:

Vitals

BP

158/98 mm Hg

CBC

Hematocrit

57%

Glycosylated hemoglobin (HbA1c)

7.3 %

Arterial Blood Gas Assessment

PaCO₂

52 mm Hg

PaO₂

48 mm Hg

Lipid Panel

Cholesterol

242 mg/dL

HDL

32 mg/dL

LDL

173 mg/dL

Triglycerides

184 mg/dL

1. What clinical findings correlate with M.K.’s chronic bronchitis? What type of treatment and recommendations would be appropriate for M.K.’s chronic bronchitis? 
2. Which type of heart failure would you suspect with M.K.? Explain the pathogenesis of how this type of heart failure develops. 
3. According to the B.P. value, what stage of hypertension is M. K. experiencing? Explain the rationale for her current medications for her hypertension. Also, discuss the impact of this disease in the U.S. population. 
4. According to the lipid panel, what other condition is M.K. at risk for? According to this case study, what other medications should be given and why? What additional findings correlate for both hypertension and Type II diabetes mellitus? 
5. Interpret the lab value for HbA1c and explain the rationale for this value in relation to normal/abnormal body function?