COPD, Heart Failure, Hypertension and Diabetes Mellitus

Some of the clinical findings that correlate with M. K’s chronic bronchitis includes coughs with septum production or acute chest illness which prolongs for quite some time are the most common manifestations of chronic bronchitis. The septum may be clear, green, yellow or even blood-tinged. The purulent septum also recorded in patients with chronic bronchitis. M.K had overweight and is a smoker, these traits found in patients suffering from chronic bronchitis. Ex-smokers demonstrate persistent markers of active inflammation of the airways in the bronchial structures. Patients with chronic inflammation have evidence of pulmonary hypertension, physiological impairments, polycythemia, cor pulmonate and PaO2 of 45 to 55 mmHg on assessment of their arterial blood gas.

M.K’s chronic bronchitis treated by administration of antibiotics which are is the supportive care patients can use. Such medicines include bronchodilators, corticosteroids and oxygen administration. These antibiotics recommended on the indication of acute exacerbation with increased coughs, septum purulence and septum volume in patients above 65 years of age. Treatment of chronic bronchitis using antibiotics is recommended for M.K unless a significant risk of serious complications shows up. M.K can also be vaccine using influenza which reduces the incidences respiratory tract infection and further decreases rates of acute bacterial bronchitis. Smoking cessation could be the most efficient recommended way to deal with chronic bronchitis. Various smoking cessation such as nicotine replacement system, behavior modification, support groups, and training can be helpful. Chronic bronchitis can also manage by eliminating exposure to irritants such deodorants, organic dust, aerosolized air noxious gasses and prolonged exposure to sulfur dioxide.

M.K exhibited a congestive heart failure (CHF) which could cause blood volume overload and high blood pressures. Primary and loss of muscle diseases and muscle output failures are some other abnormalities associated with this type of heart failure. The heart has a reduced contractility resulting into a reduced cardiac output that is insufficient to meet demands of the body. There is decreased contractility of the heart leading to a reduced cardiac output that is not enough to meet the peripheral needs. The determinants of such a heart failure include decreased contractility of the muscle increase of preload pressure resulting into left arterial congestion. There is then an increased systemic vascular resistance reducing the cardiac output even though the systematic blood pressure always reduced. Finally, the heart rate increased as a result of growth in catecholamine and sympathetic tone: this is the compensatory mechanism. In some patients with coronary disease, there is always an arising imbalance between oxygen supply and the myocardial oxygen. (Weber K.T et al., 1985)

The hypertension stage 1 is where MK fall at where the systolic pressure ranges between 140-150 mmHg and diastolic pressure ranges between 90-98 mmHg. At this stage, patients prescribed for diuretics which are drugs that lower blood pressure by aiding the body get of extra fluids and sodium. The rationale of Lotensin medication, also known as benazepril should not be taken during pregnancy as it may result in injury or death of the fetus. Lotensin does not also work with patient’s prescription, non-prescription medicines, herbs or a diet supplement. On the other hand, Lasix drug, also known as furosemide prevents too much salt absorption thus treats fluid retention and hypertension. Lasix should not take with patients who cannot urinate, have an enlarged prostate, the presence of kidney or liver related diseases.

Hypertension has brought greater effects on the United States population as there have been more than 360000 American deaths in the year 2013, blood pressure being the primary contributing cause (Merai, Siegel et al.,2016). Hypertension has been a significant public health challenge due to its very high prevalence and correlation with cardiovascular diseases and eventually resulting in a premature death. High blood pressure increases chances of infection with another illness. Women and black Americans are more likely to develop high blood pressure in their lifetime. Hypertension is a major challenge to public health; it is not only common but also one of the modifiable risk factors for stroke, coronary heart disease, association with cardiovascular infection and finally premature death of the American people. (Lawes et al., 2008, Fields et al.,2004). Hypertension is not only the most common infection, but it’s also a modifiable infection risk factor for congestive heart failure, stroke, peripheral vascular disease and coronary heart disease. This hypertension prevalence in the United States is high and increase in the recent years. This prevalence has been estimated to be about 28.9% of the total population. Infection varies with age, gender, ethnicity, race and some behavioral dietary intake of sodium and potassium, alcohol consumption, weight management, and physical activity.

According to the lipid panel MK is at increased risk for rheumatoid, periodontal disease, and rheumatoid arthritis infections including systemic lupus erythematosus. These disorders treated with medications that increase both HDL and LDL levels. Methotrexate drug increases HDL cholesterol levels associated with a decrease in inflammation and improvement in disease activity. Methotrexate drug also increases the triglycerides level but with no precise mechanism. The hydroxychloroquine medication lowers LDL cholesterol and triglycerides levels in patients with rheumatoid arthritis and systemic lupus erythematosus. Hydroxychloroquine also increases HDL levels via secondary disease improvement activity. This drug decrease number of LDL receptors contributing to reducing total cholesterol and LDL levels that are dependent on the effect of the drug in inflammation. Glucocorticoids drug in higher dosage increased the level of serum triglycerides and LDL levels by increasing secretion and production of VLDL by the liver. The effect of glucocorticoids is exhibited by the marked effects of anti-inflammatory reducing inflammation and therefore affecting lipid response. Lower dosage of this drug has minimal effect on the levels of triglycerides and LDL. Some other drugs that commonly administered to patients include TFN-alpha blocking antibody, Tofacitinib, Tocilizumab, Rituximab, Cyclosporine, and Retinoids. 

Diabetes type 2 and hypertension coexist resulting into life-threatening risks. Patients with diabetes have circadian changes in their blood pressure that correlate with nephropathy in high blood pressure. Arterial blood pressure results into renal damage representing a complicated relationship in both hypertension and diabetes type 2. hypertension accelerates the course of microvascular and macrovascular complications seen in diabetes. Hypertension precedes diabetes type 2 and vice versa. Hypertension is a common condition in patients with type 1 and two diabetes, the type 2 diabetics covering 75% of the population. Early detection and prevention of hypertension will delay the progression of diabetes. Additional factors correlating for type two diabetes and hypertension include age correlation, BMI, increased excretion urinary albumin and triglycerides. 

Finally, Glycosylated hemoglobin is a form of hemoglobin that primarily measures the concentration of plasma glucose. This test is limited to only three months as the red blood cells have a lifespan of only four months. Glycosylated hemoglobin is monitored to check for the long-term control of diabetes mellitus. Its levels increased in persons with poorly controlled diabetes mellitus. Glycosylated hemoglobin (HbA1c) at 7.3% implies a very low count of hemoglobin A1c in the red blood cells. Hemoglobin A1c is a type of protein on red cells surface where sugar molecules stick on. Higher levels of glucose in the blood will imply higher levels of hemoglobin A1c in the red cells. Hemoglobin levels decreased to below 7% indicate normal levels of Glycosylated hemoglobin. A Higher percentage of HbA1c above 7% abnormalizes the body function, showing reduced levels of Glycosylated hemoglobin. People with diabetes who keep their Glycosylated hemoglobin level close to 7% have better chances of delaying complication of diabetes which may affect nerves, kidney or the liver. 

Conclusion

Infections such as COPD, heart failure, heart pretension and diabetes mellitus can thus be screened and detected in the laboratory before an appropriate diagnosis. Diagnostic administrations can either be harmful; pose side effects to the body or restore body conditions to normal. Failure to treat combat these diseases at an earlier age may be fatal and even result in into death.

References

In Dagogo-Jack, S. (2017).  Diabetes mellitus . Cham, Switzerland: Springer.

In Shelledy, D. C., & In Peters, J. I. (2016).  Respiratory care: Patient assessment and care plan development .

Merai R, Siegel C Rakotz M, & Bastch P. (2016) Approach to Detect and Control Hypertension.Morb Mortal.

Weber KT, et al. Am J Cardiol, Janicki JS, Maskin CS. (1985) Pathophysiology of Cardiac Failure.