J.T. is a 48-year old male who presents to the primary care clinic with fatigue, weight loss, and extreme thirst and increased appetite. History of
... [Show More] Present Illness J.T. has been in his usual state of health until three weeks ago when he began experiencing symptoms of fatigue, weight loss, and extreme thirst. He reports that he would like to begin a walking program, but he feels too fatigued to walk at any point during the day. Now he is very concerned about gaining more weight since he is eating more. He reports insomnia due to having to get up and urinate greater than 4 times per night. Past Medical History Hypertension Hyperlipidemia Obesity Family History Both parents deceased Brother: Type 2 diabetes Social History Denies smoking Denies alcohol or recreational drug use Landscaper Allergies No Known Drug Allergies Medications Lisinopril 20 mg once daily by mouth Atorvastatin 20 mg once daily by mouth Aspirin 81 mg once daily by mouth Multivitamin once daily by mouth Review of Systems Constitutional: – fever, – chills, – weight loss. Neurological: denies dizziness or disorientation HEENT: Denies nasal congestion, rhinorrhea or sore throat. Chest: + Denies cough. Heart: Denies chest pain, chest pressure or palpitations. Lymph: Denies lymph node swelling. General Physical Exam Constitutional: Alert and oriented male in no acute distress Vital Signs: BP-136/80, T-98.6 F, P-78, RR-20 Wt. 240 lbs., Ht. 5’8″, BMI 36.5 HEENT Eyes: Pupils equal, round and reactive to light and accommodation, normal conjunctiva. Ears: Tympanic membranes intact. Nose: Bilateral nasal turbinates without redness or swelling. Nares patent. Mouth: Oropharynx No mouth lesions. Teeth present and intact; Oral mucous membranes and lips dry. Neck/Lymph Nodes Neck supple without JVD. No lymphadenopathy, masses or carotid bruits. Lungs Bilateral breath sounds clear throughout lung fields. Breathing quality deep with fruity breath odor Heart S1 and S2 regular rate and rhythm; tachycardia; no rubs or murmurs. Integumentary System Skin warm, dry; Nail beds pink without clubbing. Labs J.T. is diagnosed with diabetes. Review all information provided in the case to answer the following questions. Case Study Questions Pathophysiology & Clinical Findings of the Disease Review the lab findings and decide if the diagnosis is Type 2 or Type 1 Diabetes Mell..... [Show Less]