FELIPE GARCIA 57 YEAR OLD REASON FOR
ENCOUNTER HIGHBLOOD PRESSURE
LATEST CASE 2025
What are the ADA's phsycian tasks for diabetes care (5)? - answer-1. work to
detect diabetes complications and potential comorbidities
2. review previous treatment and risk factor control
3. begin patient engagement in the formulation of a care management paln
4. review and discuss prevention of complications
5. develop a plan for continuing care
Relevant medical history for a patient with diabetes? - answer-
Advantages/Disadvantages of EMR - answer-1. offers template that increases
likelihood that pt receive recommended care
2. provides tools to evaluate pt care across an entire population
3. allows documentation of improved physician performance, which may
increase reimbursements by some insurers
-------------------------
4. Has been shown to interrupt the physician-pt relationship (screen gaze)
,What symptoms of hyperthyroidism complicate diabetes management? -
answer-Fatigue, Depression, Dyslipidemia
Type 1 DM is associated with which thyroid diseases? - answer-T1DM is an
autoimmune illness and is associated with both Graves disease and Hashimoto
disease
DKA in T1DM v. T2DM - answer-Pts with T1DM get DKA
Pts with T2DM more often get HHS
pts with T2DM can develop DKA when over time, T2DM starts to resemble
T1DM as pancreatic function dwindles and pts may begin to require insulin. If
deficiency is severe enough, a pt with T2DM may produce ketones and develop
hyperglycemia.
Ex. a T2DM elderly pt who becomes acutely ill could easily develop DKA
Screening for T2DM ADA Recommendations (11) - answer-1. Overweight or
obese patients (BMI ≥ 25 kg/m2 or ≥ 23 kg/m 2 in Asian Americans) who have 1
or more:
-Physical inactivity
-High-risk race/ethnicity (Native American, Pacific Islander, Latino, African
American, Asian American)
-1st-degree relative with DM
,-Previously dx'd impaired fasting glucose (100-125 mg/dL) or impaired glucose
tolerance (2-hr plasma > 140 mg/dL following 75g glucose load)
-Stage 2 HTN (≥140/90 mmHg or on therapy)
-HDL < 35 mg/dL and/or TG > 250 mg/dL (2.83 mmol/L)
-Hx of GDM
-PCOS
-Hx of CVD
-A1c ≥5.7%, impaired glucose tolerance, or impaired fasting glucose on
previous testing
-Other clinical conditions associated with insulin resistance (e.g., acanthosis
nigricans, severe obesity)
What is the prevalence of DM in those 18 and older? 65 and older? - answer-
18 and older: 30.2 million or 12.2% of all people in this age group
65 and older: 12 million or 25.5% of people in this age group
What is race breakdown of DM for
-nonhispanic whites
-Asian americans
-hispanics
-non-hispanic blacks
-american indians/alaska natives - answer--Non-hispanic whites: 7.4%
, -8% of Asian Americans
-12.1% of Hispanics
-12.7% of non-hispanic blacks
-15.1% of american indians/alaska natives
What are rates of diabetes among hispanics from different regions? - answer--
8.5% for Central/South Americans
-9% Cubans
-12% Puerto Ricans
-13.8% Mexican Americans
How does laser photocoagulation treatment help with retinopathy? - answer-
Slows the progression of retinopathy and reduce vision loss, but doesn't
restore lost vision.
Important to identify and treat patients early since retinopathy is
asymptomatic in early course and the treatment is aimed at preventing vision
loss
What findings should one see in severe, non-proliferative retinopathy? -
answer-1. retinal hemorrhages- dark blots with indistinct borderst that indicate
partial obstruction and infarction
2. Cotton wool spots- white spots with fuzzy borders and they indicate areas of
previous infarction. Accompany hemorrhages
ENCOUNTER HIGHBLOOD PRESSURE
LATEST CASE 2025
What are the ADA's phsycian tasks for diabetes care (5)? - answer-1. work to
detect diabetes complications and potential comorbidities
2. review previous treatment and risk factor control
3. begin patient engagement in the formulation of a care management paln
4. review and discuss prevention of complications
5. develop a plan for continuing care
Relevant medical history for a patient with diabetes? - answer-
Advantages/Disadvantages of EMR - answer-1. offers template that increases
likelihood that pt receive recommended care
2. provides tools to evaluate pt care across an entire population
3. allows documentation of improved physician performance, which may
increase reimbursements by some insurers
-------------------------
4. Has been shown to interrupt the physician-pt relationship (screen gaze)
,What symptoms of hyperthyroidism complicate diabetes management? -
answer-Fatigue, Depression, Dyslipidemia
Type 1 DM is associated with which thyroid diseases? - answer-T1DM is an
autoimmune illness and is associated with both Graves disease and Hashimoto
disease
DKA in T1DM v. T2DM - answer-Pts with T1DM get DKA
Pts with T2DM more often get HHS
pts with T2DM can develop DKA when over time, T2DM starts to resemble
T1DM as pancreatic function dwindles and pts may begin to require insulin. If
deficiency is severe enough, a pt with T2DM may produce ketones and develop
hyperglycemia.
Ex. a T2DM elderly pt who becomes acutely ill could easily develop DKA
Screening for T2DM ADA Recommendations (11) - answer-1. Overweight or
obese patients (BMI ≥ 25 kg/m2 or ≥ 23 kg/m 2 in Asian Americans) who have 1
or more:
-Physical inactivity
-High-risk race/ethnicity (Native American, Pacific Islander, Latino, African
American, Asian American)
-1st-degree relative with DM
,-Previously dx'd impaired fasting glucose (100-125 mg/dL) or impaired glucose
tolerance (2-hr plasma > 140 mg/dL following 75g glucose load)
-Stage 2 HTN (≥140/90 mmHg or on therapy)
-HDL < 35 mg/dL and/or TG > 250 mg/dL (2.83 mmol/L)
-Hx of GDM
-PCOS
-Hx of CVD
-A1c ≥5.7%, impaired glucose tolerance, or impaired fasting glucose on
previous testing
-Other clinical conditions associated with insulin resistance (e.g., acanthosis
nigricans, severe obesity)
What is the prevalence of DM in those 18 and older? 65 and older? - answer-
18 and older: 30.2 million or 12.2% of all people in this age group
65 and older: 12 million or 25.5% of people in this age group
What is race breakdown of DM for
-nonhispanic whites
-Asian americans
-hispanics
-non-hispanic blacks
-american indians/alaska natives - answer--Non-hispanic whites: 7.4%
, -8% of Asian Americans
-12.1% of Hispanics
-12.7% of non-hispanic blacks
-15.1% of american indians/alaska natives
What are rates of diabetes among hispanics from different regions? - answer--
8.5% for Central/South Americans
-9% Cubans
-12% Puerto Ricans
-13.8% Mexican Americans
How does laser photocoagulation treatment help with retinopathy? - answer-
Slows the progression of retinopathy and reduce vision loss, but doesn't
restore lost vision.
Important to identify and treat patients early since retinopathy is
asymptomatic in early course and the treatment is aimed at preventing vision
loss
What findings should one see in severe, non-proliferative retinopathy? -
answer-1. retinal hemorrhages- dark blots with indistinct borderst that indicate
partial obstruction and infarction
2. Cotton wool spots- white spots with fuzzy borders and they indicate areas of
previous infarction. Accompany hemorrhages
