Open Question: What diagnostic tests and medications are needed for this patient?
A 62-year old male(non-smoker, no known allergies) has the following medical conditions:
Characteristics of angina commonly include a sensation of pressure, heavy weight, burning, or tightness over the sternum or near to it. The pain may radiate to, or occassionally be limited to, the left arm, shoulder, or other areas. The sensation gradually increases in intensity and then gradually disappears with rest. The duration is usually between 30 seconds and 30 minutes.
Hypertension is defined by persistent elevation of arterial blood pressure.
Hyperlipidemia is defined as an elevation of one or more of the following: cholesterol, cholesterol esters, phospholipids or triglycerides. Abnormalities of plasma lipids can result in a predisposition to coronary, cerebrovascular, and peripheral vascular arterial disease.
He is taking the following medications:
Irbesartan 300mg mane(what does “mane” mean?)
Used for treatment of hypertension and prevention of renal disease progression in patients with type 2 diabetes, hypertention and microalbuminuria.
Gemfibrozil 600mg bd(twice daily)
Used in treatment of severe hypertriglyceridaemia, mixed hyperlipidaemia and dyslipidaemia associated with diabetes, and used to reduce risk of coronary heart disease in hypercholesterolaemia.
Glyceryl Trinitrate Tablets 600mcg; half to one prn(when necessary)
Used in the prevention and treatment of stable and angina and heart failure associated with acute myocardial infarction. Provides exogenous source of nitric oxide. Predominantly venodilators and reduces venous return and preload to the heart, reducing myocardial oxygen requirement.
Glyceryl Trinitrate spray 400mcg (1 spray when required); use prn
Also known as nitroglycerine and GTN. It is used in the treatment of angina by providing an exgenous source of nitric oxide which mediates vasodilator effects.
His medical test results are:
-Blood Pressure 140/90
-Liver Function Test
Total protein=63g/L(normal 60-80g/L);Albumin 27g/L(normal 35-52g/L);ALT=19U/L(normal 38-126U/L);GGT=154U/L(normal 12-43U/L);ALP=177(normal 38-126U/L)
Question 1: From the liver function test results, what information can we obtain regarding the patient’s medical condition?
Question 2: What further diagnostic tests are needed to know more about the patient’s medical condition(including diabetes due to heavy weight)?
Question 3: What are the appropriate therapies(what medicines, and dosage for each?) for effective treatment, avoidance of side effects, increased compliance, and cost-effectiveness?
Question 4: Without other symptoms, the patient shows dry cough. What is the cause of this cough?
Sat, 16 Aug 2008 06:59:51 GMT
Open Question: Mysterious high recurring fevers?
For four months now my 6 yr old has had high recurring fevers. Up to 106. Now she has been working with a several doctors who are all stumped. She does not have lupus, malaria, leukemia, FAPA, Lyme disease and RJA Rheumatic fever parvo and Kawasaki’s have also been ruled out. She experiences joint pain but no inflammation or swelling. Fatigue, lack of appetite, slight weight loss, head aches, and a hard time sleeping are her main symptoms. She has had an echo on her heart because of a murmur that started with the fevers, an ultrasound on her abdomen and several blood tests. All of these came back negative. My daughter?s pediatrician has been working with a rheumatologist/immunologist and an infectious disease specialist. Everyone is stumped. I’m guess I’m just hoping that this by chance might sound familiar to someone and can give us all a hand in coming up with something. I just want my daughter to be well and at this point all we’ve got is Tylenol and ibuprofen to ease the fevers. Thanks to anyone who can help.
Thank you inzanium. They did a bone marrow biopsy that was negative and not swollen glands. Thank you learning I will check out that site and see if anything clicks
Fri, 15 Aug 2008 21:27:49 GMT
