Case DM

Table of Contents

• Case Studies
  • Case-9: Diabetes Mellitus
    • Patient Brief Record / Brief Scenario
    • Patient’s Scenario/ Instructions to Patient
    • Attachments
    • Notes

Case Studies

Case-9: Diabetes Mellitus

Patient Brief Record / Brief Scenario

Information for student about the case

• Patient Name: Jamal
• Age: 40 years
• Occupation: Secretary in a private company
• No frequent visits to the clinic
• Lab investigations performed outside showed FBS: 9.00 mmol/l.

FBS done here showed: 10.1 mmol/l (181.8 mg/dl)

• Today:
  • BP: 120/80
  • Weight: 70 kg
  • Height: 160 cm

Jamal is a 40-year-old man who came with the complaint of polyuria and increased thirst.

TASK: (What is expected from a student?)

• Take a focused and relevant history to help diagnose and manage the patient’s problem.
• Perform the relevant clinical examination and examine the patient’s feet.
• Inform the patient about the diagnosis.
• Explain to the patient the management plan.
• Write a referral letter for the patient to a relevant specialist.

Patient’s Scenario/ Instructions to Patient

You are a 40-year-old man who works as a secretary in a private company. You have come to the clinic today with the complaint of polyuria and increased thirst. You have done your fasting blood sugar, which was high. You were informed about the possibility of being diabetic.

Opening scenario: You have come to see your results of blood sugar, as you have increased thirst and urination (You will admit only this).

Tell your doctor about the following information only if specifically asked about:

• The symptoms of polyuria and increased thirst started 2-3 weeks ago.
• Apart from increased micturition and thirst, you do not feel any other symptoms.
• You do not use any medication.
• You are a non-smoker.
• Your mother is diabetic and had two toes amputated and renal failure. She is on dialysis.
• Your father is hypertensive.
• No recent investigations have been performed apart from fasting blood sugar.
• You are not known to have any other chronic illnesses.
• You do not perform any regular exercise.
• Patient’s idea: It is a serious problem.
• Concern: Like your mother, you will suffer from complications.
• Expectation: To get medication that will save you from complications.
• Any other points, please relate to your own personal and family history.

Important Notes for the SP:

• You have come to recheck today to see if you are diabetic or not.
• The student will examine your feet and perform other simple clinical examinations.
• Any other information should be given to the doctor only when he asks you.

case dm students

Table of Contents

• Case Studies
  • Case-3: Chest Pain
    • Patient Brief Record / Brief Scenario
      • Information for Student about the Case
      • TASK: (What is expected from a student?)
    • Patient Brief Record / Brief Scenario
      • Information for the Simulated Patient
      • Important Notes for the Simulated Patient
    • Notes

Case Studies

Case-3: Chest Pain

Patient Brief Record / Brief Scenario

Information for Student about the Case

• Patient Name: Ahmad
• Age: 50 years
• Occupation: Employee at a private company
• Today BP: 150/90 mm Hg
• Weight: 90 kg
• Height: 170 cm

Mr. Ahmad is a 50-year-old man who has been experiencing chest pain on and off for the past few weeks.

TASK: (What is expected from a student?)

• Take a focused history to reach a probable diagnosis.
• Perform a cardiovascular system examination.
• Inform the patient about the possible diagnosis.
• Provide appropriate advice regarding lifestyle modifications.
• Explain the management plan to the patient.

Patient Brief Record / Brief Scenario

Information for the Simulated Patient

• Patient Name: Ahmad
• Age: 50 years
• Occupation: Employee at a private company
• Marital Status: Married, with 2 children (18 and 20 years old).

You are a 50-year-old man who works as an employee at a private company. For the past few weeks, you have been experiencing on-and-off chest pain.

Opening Scenario: “I have chest pain, doctor.” (You will admit only this information.)

Tell your doctor about the following information only if specifically asked about:

• Complaint of chest pain over the past few weeks.
• Pain usually comes on exertion, especially when climbing stairs.
• No history of trauma.
• You smoke 20 cigarettes per day.
• You have gained about 10 kg in the past 6 months.
• You are generally well apart from this chest pain.
• Your working hours are 8:00 AM to 5:00 PM.
• Some stress at work when you have to do too much paperwork.
• No stress at home.
• Your BP was taken by the nurse today and was found to be slightly high, repeated twice.
• You lead a sedentary lifestyle with no regular exercise.
• Your father died of a heart attack at the age of 55.
• Your mother is diabetic and hypertensive.
• Patient’s Idea: Possibly hypertension.
• Concern: Heart attack, as your father had one.
• Expectation: To confirm the diagnosis of hypertension to start treatment.

SAY NO TO ANY OTHER QUESTIONS RELATED TO ANY SYMPTOMS.

Important Notes for the Simulated Patient

• The doctor will examine your chest to confirm the diagnosis.