Complete the case study by answering the questions associated with the scenario.
You have a patient that presents to your office with the following for initial visit:
• 42-year-old Caucasian female, BMI 45, BP: 152/86, Pulse: 91, O2: 97%
• Past Medical Hx: Hypertension, Diabetes Type 2, Osteoarthritis, Chronic Migraine
• Past Surgical Hx: none
• Social: Occasional Smoker, Occasional alcohol use (1-2 per week), no drug use
• Most recent labs (that you had access to):
o Total Cholesterol: 301, Triglycerides- 473, HDL- 19, LDL- 48
o Thyroid function tests: WNL
o Fasting glucose: 189
o A1C: 8.9
Patient reports that she has been prescribed Metformin in the past but does not use this every day. She reports
failing several diets that were recommended by her previous provider. She states, ‘I don’t have time for
exercise’ and ‘I can’t afford a gym membership.’ She thinks there may have been a blood pressure pill
prescribed in the past but she’s not sure.
Based on the scenario provided, fully inform your patient and explain their diagnosis.
Use UpToDate located in the University Library to search for and locate the most current evidence-based
guidelines to answer the following questions.
Overall Health and Pathophysiology
• What do you think is going on with the overall health of this patient? Describe in detail the pathophysiology as
it relates to her current presentation and symptoms.
Risk Factors
• Discuss at least 5 of the associated risk factors for this patient and diseases they may be at risk for in the
• List your diagnoses for this patient based on your assessment. Describe your proposed treatment plan to
address the current state of health and diagnoses you have identified, including strategies to modify at least 3
risk factors. (You can mention specific medications if you choose, but it is not required.)
Patient Education
• What education would you provide to the patient regarding their diagnosis, prognosis, and requirements
needed to execute your treatment plan?



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