Diseases manifest differently, either as a presentation of an underlying condition or predisposing risk factor. A proper understanding of the underlying illness confers proper management by the healthcare providers based on the presenting complaints. In Mr. C’s case, he has morbid obesity, an underlying primary condition that has predisposed him to various chronic illnesses. He reportedly has elevated blood pressure, diabetes mellitus, sleep apnea, dyspnea on exertion, dyslipidemia, and chronic renal disease. Laboratory investigations show deranged kidney functions. the discussion below aims to highlight clinical manifestations, and risk factors of obesity, assess functional health patterns and consider renal disease (end-stage) management.
Clinical manifestation of the disease is derived from the patient’s symptoms (subjective data), examination of the patient, as well as laboratory investigations (objective data). Mr. C is a case of obesity which has predisposed him to other illnesses. He currently complains of dyspnea on exertion, sleep apnea, and skin itchiness. He also has swollen limbs. On examination, Mr. C has 3+ bilateral pitting edema. His laboratory findings indicate that his fasting blood sugar is 146 mg/dl. This points to diabetes as per (Chatterjee & Davies, 2018), which is defined by blood glucose >126mg/dl. Body weight and height give an estimation of the general health status of an individual, a parameter called body mass index (BMI), which estimates the overall body store of fat. (Shan et al., 2019). A BMI of 18.5- 24.5 is considered normal, whereas a BMI of 25.5- 29.9 is overweight. BMI of above 30 is obese, graded into 3 classes with BMI > 40 being morbid obesity. Obesity is a risk factor for diabetes, hypertension, and renal disease. Increased accumulation of fat in the blood vessels leads to narrowing and resultant hypertension. Laboratory findings show derangement in his lipid profile. He has elevated cholesterol levels (normal is <200mg/dl) as well as hypertriglyceridemia (normal- 40- 140). His HDL is low (normal is >40 in a male adult). He also has deranged urea and creatinine levels pointing to kidney problems. He presents with itchiness, which can e attributed to the accumulation of urea, pointing to uraemic pruritus. This could be a chronic renal disease, with obesity as the primary complicating condition. Uraemia points to end-stage renal disease (ESRD).
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