Dyslipidemia Case Studies

No scalp lesions. Dry eyes with conjunctival injection. Mild exophthalmos. Dry nasal mucosa. Marked cracking and bleeding of her lips with erosions of the mucosa. She has a large ulceration of the mucosa at the bite margin on the left. She has some scattered ulcerations on her hard and soft palette. She has difficulty opening her mouth because of pain. Tonsils not enlarged. No visible exudate. SKIN: She has some mild ecchymosis on her skin and some erythema, she has some patches but no obvious skin breakdown. She had some fissuring in the buttocks crease. PULMONARY: Clear to precussion and auscultation, bilaterally. CARDIOVASCULAR: No murmurs or gallops noted. ABDOMEN: Soft, non-tender, protuberant, no organomegaly, and positive bowel sounds. NORALOGIC EXAME: Cranial nerves ii – xii are grossly intact, diffuse hyporeflexia. MUSCULAR SKELETAL: Erosive destructive changes in elbows, wrist, and hands consistent with rheumatoid arthritis. Has had bilateral total knee replacements with stovepipe legs and perimalledal pitting edema 1+. I feel no pulse distally in either leg. PHYCIATRIC: Patient is a little anxious about these new symptoms and there significance. We discussed her situation and I offered her psychiatric services, she refused for now.

My patient is a 58-year-old female, who presents with controlled type II diabetes, hypertension, and possibly thyroid tumors that have been there for a few years. She is under the care of a physician for her diabetes and associated controlled hypertension. I recommended several times that she see her physician after feeling the tumors around her neck and thyroid. Her medical history also indicates that she had rheumatic fever twelve to thirteen years ago, has arthritis in her knees, and occasional headaches. She is 5”3 and weighs 216 pounds. Her blood pressure was 126/80, pulse was 88 BPM, respirations were 20, and her temperature was 98.2 Fahrenheit. She doesn’t smoke and I made sure that she had eaten lunch and wasn’t hungry. She is currently on 100 mg Metformin for her diabetes, 120 mg. Lisinopril for hypertension, 40 mg. of Lovastatin to lower cholesterol, 80 mg. of Aspirin to prevent cardiovascular disease, and daily insulin. Reviewing her medical HX, I was informed that she usually checks her blood glucose daily, but had recently run out of strips, so it had been a

She reports a history of back pain, ovarian cysts excision, and breast tumor. She denies chest pain, shortness of breath, or palpitations. Patient reports that her immunizations and preventive care are up to

A review of her medical records indicates that she has not had any significant health events, such as falls or hospitalization since her last visit. She suffers from chronic stable hypothyroid, chronic DM which is mange with medication and chronic neuropathy.

Per medical records (2008-2014), the claimant had a history of multiple medical issues, including migraines, right hand tremors, alcohol abuse, obesity, gastro-esophageal reflux disease (GERD), nausea, abdominal pain, endometriosis and degenerative changes in the left knee. In 2014, she was evaluated for hip

4. A 79-year-old female present with her daughter for ongoing fatigue also noted to have lost 5 pounds over past 6 months. No night sweats or fevers. Pertinent past medical history includes severe, generalized osteoarthritis, hypertension, type 2 diabetes mellitus and depression. She is taking the following medications: acetaminophen 650mg every eight hours, Lyrica 75 mg twice daily; alendronate 70 mg once weekly, valsartan 320 mg once daily, fluoxetine 40mg once daily and insulin glargine 20 units once daily. Your exam reveals slight pale conjunctivae, a 2/6 systolic ejection murmur and generalized arthritic joints in her extremities. A point of care test results in a hemoglobin of 10.2 g/dL. Complete blood cell count is done; results

Claimant reports history of multiple medical complaints. Since the age of 60 she reports struggling with urinary incontinence, which impacts her functioning at work. She reports feeling ashamed and guilty that she is unable to control her urination and has the need to periodically utilize the restroom or

CC Mrs. Lawson Boice is a 69-year-old female here today for a followup. HPI The patient was last seen in the office in February. Please see that note for complete details. She has several issues she would like to discuss today. She tells me that she has really been under a lot of stress of late. She had been caring for her sister, who has uterine cancer. In addition, her husband 's brother recently died, and there have been issues regarding a property they co-owned. She sold her house in New York and is now renting a house here in Portsmouth. She feels all that she has been doing is moving and cleaning. She feels that she is a little bit settled, however and is hoping that she can get back to her normal regimen. She has not been walking as much as typical, and she would like to lose a couple of pounds and plans to get back into that, as well as her physical therapy exercises that she has been doing for her neuropathy.

Physical Assessment (Adult) Student: Mayra Villagomez Date: June 3, 2016 Identifying Data Name: L. V. Source: Patient Age: 51 Date of Birth: June 14, 1964 Race: Hispanic Subjective data: L.V. is a 51-year-old Hispanic female. She is 5’4 height and 150 lbs. Patient denies pain, discomfort, or chest pain during physical assessment. Patient is allergic to Aspirin she states that she gets rashes when she takes it. She was diagnosed with thyroid cancer 5 years ago and got her thyroid glands surgically removed. Patient denies the use of tobacco and drinks 2-3 beers on special occasions. Patient works for an American Restaurant as a server, she’s been serving for over ten years. Patient states that she’ll be getting her first colonoscopy next month and she just recently got her yearly mammogram done and results were normal. Immunizations are up to date and she gets the flu shot every year. Patient has four daughters and has been happily married for 20 years. Patient denies using glasses or contacts she visits her optometrist every year and has never had a problem with her vision.

HPI The patient tells me she has type 2 diabetes, diagnosed approximately six or seven years ago. She has been on the same medication regimen for about the last year. The latest medication to be added was Januvia 100 mg daily. Prior to that, she has been on metformin ER 2000 mg daily, as well as glyburide 10 mg daily. She does check her glucose levels regularly. She tells me her morning glucose, two hours after eating a "sugary cereal" was 187. She admits that she does not make the best diet choices regularly. She tells me she has been to diabetes education as well as nutrition education and she struggles with making those

Son age 64, alive with history of Cancer / Hypertension Daughter 57, alive with Multiple Sclerosis / Hypertension / Diverticulitis Daughter 48, alive with Fibromyalgia Son [adopted] age 46, alive with Hypertension Son who passed away at age 6 ROS General: Describes health status as “fair”. Height attained 5’2” weight 183 lbs. Patient states she has not experienced any changes in her weight over the past couple of months. Her ability to do activities has decreased since diagnosed with COPD and Congestive Heart Failure. She notices walking from the car into the house or activities such as watering the garden take more of an effort and her breathing becomes labored. Denies fever, chills, sweats, or night sweats unless exacerbation of respiratory problem. She states her living situation is “good”; she lives in a single story house on her own and able to perform activities of daily living.

Based off these measurements, M.G has hypertension and if not taken care of, her blood pressure could lead to a hypertensive crisis. During M.G’s physical her lab results showed her fasting blood sugar to be 200 mg/dl, total cholesterol 280 mg/dl, HDL cholesterol 30 mg/dl, LDL cholesterol 180 mg/dl, and triglycerides 200 mg/dl. Normal levels for fasting blood sugar are100 mg/dl or less, good total cholesterol is below 200 mg/dl, LDL cholesterol levels best for people at risk of heart disease are below 100 mg/dl, HDL cholesterol levels of 60 mg/dl and above are good, and lastly triglyceride levels below 150 mg/dl are considered good. When comparing M.G’s level’s to normal levels you notice that her fasting blood sugar is double the normal amount, and her total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides levels are all considered high/poor. With looking specifically at M.G’s fasting blood sugar, you can see her levels are well pass being considered pre diabetes, and are we'll over the diabetes standard level of 126 mg/dl. Overall, M.G’s poor lab results verify her diagnosis of type 2 diabetes and show how serious her condition is, especially if it is not

As important as medication therapy is, there seems to be gender disparities with the management of lipid lowering medication therapy. Women are not being as aggressively treated as their male counterparts, despite the higher baseline levels of LDL cholesterol. In Addition, women are not as likely to continue the lipid lowering therapy in the long term due possibly to the side effects of continued therapy. Providers need to increase their awareness of the cardiovascular risks of women, including addressing the barriers of assessment, lipid screening, and targeted therapies, especially for those most at risk. (Rodriguez, 2016)

She states she met with her PCP/Dr. Alice V Coghill on 1/18/2016, for a monthly exam. She continues to report the Dr. provided her with medication script refill for two months she continues to take the following medications: Omeprazole DR 20mg, Lisinopril 5mg, and Hydrocortisone Cream 1%. She also mentioned she was referred to see the gastroenterology and an appointment is scheduled for 1/21/2015. She also reported on 1/18/2016 she met with Dr. Harold Paez/Podiatry and she was told by Dr. Paez that she has sprained ankle (right foot) and she will need physical therapy. Client Physical therapy referral it’s pending. Next upcoming appointment with Dr. Paez is scheduled for