Question

A 30-year-old obese woman presents to your office with a chief complaint of recurrent yeast infections and increased thirst. She also has noticed increased urinary frequency, but believes this is related to her yeast infection. Over the last several years, she has gained more than 40 lb despite having tried numerous diets, most recently a low-carbohydrate, high-fat diet. The patient’s only other pertinent history is that she was told to “watch her diet” during pregnancy because of excessive weight gain. Her family history is unknown, as she was adopted. On physical examination, her blood pressure is 145/92 mm Hg, her pulse is 72 beats/min, and her respiratory rate is 16 breaths/min. Her height is 65 in and her weight is 223 lb (body mass index [BMI] = 37.1). Her physical examination reveals darkened skin that appears to be thickened on the back of her neck and moist, reddened skin beneath her breasts. Her pelvic examination reveals a thick, white, vaginal discharge. A wet preparation from the vaginal discharge reveals branching hyphae consistent with Candida species. A urinalysis is negative for leukocyte esterase, nitrites, protein, but is positive for glucose.

-Based on the above history what is your most likely diagnosis for this patient?

-What are the risk factors for developing the disease you have diagnosed?

-What initial medication would you like this patient to be on and why?

-What is the mechanism of action for the drug you have selected above?

-What patient education do you as a provider need to provide to this patient about the medication that you have selected?

Answer 1

ANSWERS :

1. Based on the above history of patient the diagnosis for the patient is Diabetes mellitus and yeast infection

2. The risk factors for developing of the disease are obesity, high blood pressure

3. The initial treatment to be given to patient is anti fungal medications. They are available in the form of topical creams and oral medications. Applying of anti fungal agents on the affected part of the body the spread of infection is reduced and vaginal discharges comes down with the use of medications.