Diabetes and hypertension

1. John, an overweight 49-year-old man with history of diabetes and hypertension is playing soccer. After half an hour of an intense game, he feels severe chest pain that travels to his lower jaw. He is pale, diaphoretic, and short in breath. Upon arrival to the ER, an ECG was taken and the results show the following (note the changes in leads II, III and aVF):
Choose 3 out of the 5 prompts and answer:
1. What could be the possible reason for John’s chest pain? Explain your answer based on the clinical information.
2. How do you know John’s chest pain is heart related? How do you rule out other etiologies of chest pain such as musculoskeletal, pneumonia, and gastric sources?
3. What actions should John’s teammates have taken at the scene to help him?
4. How do you differentiate between heart attack and myocardial infarction?
?5. What is TPA? Explain how it relieves the chest pain and how it improves the survival rate in a patient with acute myocardial infarction.

2. D. D. is a 66 year-old female suffering from shortness of breath. She smoked 2 packs a day until she quit 2 years ago. She has a history of bronchiolitis, hyperinflated lungs, pulmonary edema, and syncope. Her primary care practitioner suspects she also has pulmonary hypertension (PH). After examination, D. D. has a PAP of 35mmHg and mild CHF.
Citing scholarly resources, answer the following questions:
What is pulmonary hypertension and how could D. D. have developed PH?
How does her history fit in with her new diagnosis?
In addition to the two questions above, select ONE other question from the list below to complete your discussion post. Be sure to cite the sources of your information and clearly identify which supplemental question you chose to answer.
How many patients are suffering from COPD in the United States? Do COPD sufferers die of respiratory causes or other causes? (Be sure to cite the data.)
What two separate diseases are the main COPD diseases? Give background on each disease.
How does COPD correlate with left ventricular pressure and primary heart failure?
What are the three types of bronchodilators, and how do they function to alleviate the symptoms of COPD? What are other possible treatments for COPD?
Through which mechanism does bronchiolitis cause destruction of alveoli? Is emphysema genetic? Can environmental factors increase the risk of emphysema? Why or why not?
Is lung transplantation a solution for emphysema? Can new technology be useful in the treatment of emphysema? Why or why not?