Question

Case Studies: (state whether medical clearance is recommend or not risk factors; highlight or circle them) Case Study #1 (2 points) Mertle is a 51 year old white female, height 66", weight 170 lbs. She is a retired Army officer. She has smoked approximately 2 packs of cigarettes per day for the last thirty-five years. Present activities include golf (walking with clubs) and tennis, each 5 days/wk. No history of CAD in her family. Present bp is 158/90 mmHg and RHR is 75 bpm. TC-189 mg/dL, LDL 139 mg/dL, glucose 100 mg/dL. She has a heart murmur. Her last physical was approx. 2 years ago. Case Study #2 Ed is a 43 year old male, height 5'7", weight 150 lbs. He is a grammar school teacher and he walksjogs in the high school gym for 30min 5 times a week after school. His bp is 120/84 mm Hg. TC 175 mg/dL, LDL-113 mg/dL, HDL-40 mg/dL, glucose = 105 mg/dL. He does not smoke or drink and does not have any physical complaints other than his knee problem. Family history shows father had coronary bypass sugery at age 53. He currently does not report can signs/symptoms. (2 points) (2 points Case Study #3 Mr. G is a 51 year old bank executive who is 5'8" and weighs 182 lbs. He has been a heavy smoker all his life, but states that he quit a month ago. He has Type II diabetes managed by oral hypoglycemic medications, bp of 160/90 mm Hg, glucose- 136 mg/dL, TC-246 mg/dL, LDL - 195 mg/dL, HDL 39 mg/dL. Family history reveals his mother died of kidney failure at age 52 and his father is alive and well at age 74. Mr. G lifts weights for 15 minutes in his garage 2 days/wk. (2 points) Case Study #4 Jane is a 29 year old female who plays competitive tennis 6 days/wk. Her weight is 125 Ibs and height is 5'7". She works for the postal resting bp 118/73 mm Hg and RHR 59 bpm. TC- 190 mg/dL, LDL-120 mg/d HDL 66 mg/dL, g nonsmoker. She recently had a physical 2 months prior I service delivering mail in her city. Her L, lucose 89 mg/dL. She has no family history of CAD. She has asthma. She is a

Answer 1

Case study 1. Answer :

Yes, medical clearance is recommended. That means before going to do or to perform surgery the surgeon wants medical clearance of clients from the respective physicians. To avoid complications during and after the surgery.

CAD risk factors :

* Age factors here the client having 51 years older adult near to the old age.

* cigarettes smoking, here she is having a habit of cigarettes smoking two packets per day since 35 years, so she is chronic smoker.

* blood pressure, here client blood pressure is 158/90mm of hg.

* Here client is having LDL levels are more that is 139 mg per dl. So, 130 - 169 is the border line risk to get heart diseases.

* over weight, here the client BODY MASS INDEX is 27.73kg / meter square, it indicates over weight of client. Because above 25 kg per meter square we can consider as over weight.

So, these are the risk factors for coronary heart diseases for the Mrs. Mertle. So the medical clearance is necessary.

Q. No case study 2. Answer :

Medical clearance is recommended because,

For knee problems orthoclearence is needed.

Risk factors :

* obesity, here the client BMI is 32. 85 kg per meter square.

* increased LDL levels ,that is 113 mg per dl. Normal is below 100 mg per dl.

* HDL levels are in border line, that means here client is having 40 mg per dl. Below 40 leads to risk for get heart diseases.

* He is having a family history, so it is also one of risk factor for coronary heart diseases.

Case study 3 Answer :

Mr. G also need medical clearance for blood pressure and diabetes from physicians.

Risk factors :

* here client is obese because BMI is 38.19 kg per meter square.

* chronic smoker because since so many years, more than 20 years it is a risk for developing of heart diseases.

* Low HDL leaves risk, here below 40 mg per dl. That is 39 mg per dl.

* high blood pressure that is 160 / 90 mm of hg.

* high LDL levels those are 195 mg per dl.

* family history of kidney disease this is interlinked with heart diseases.

These are risk factors of Mr. G to develop coronary heart diseases.

Case study 4. Answer :

* She needs medical clearance for Asthma.

Risk factors :

* over weight , because BMI is 27.34 kg per meter square.

* Bradycardia leads to heart attacks.

* increased LDL levels 120 mg per dl.

* having a family history of CAD these are the risk factors for developing a coronary artery diseases in Mrs. Jane.