1. Question : An established patient is seen in the hospital on day two of his hospital stay. The patient had been admitted through the emergency department with status asthmaticus and had been undergoing extensive respiratory therapy over the past 24 to 30 hours. The physician performs a detailed interval history and a detailed physical exam. The possibility of pneumonia complicating the asthma must be considered. The patient’s respiratory condition is still unstable. The MDM complexity was high.

Question 2. Question : A 13-year-old male was admitted yesterday for a tympanotomy. Post surgically, the child developed fever and seizures of unknown origin. A pediatric consultation was requested. This was done on the second hospital admission day and 24 hours after surgery. The history of present illness (HPI) was extended with a complete review of systems (ROS). A complete past/family/social history (PFSH) was elicited from the mother as part of a comprehensive history. A comprehensive examination was conducted on all body areas and organ systems. The MDM complexity was high.

Question 3. Question : A full-term healthy newborn girl received initial and subsequent hospital care services on July 7 and July 8, respectively.

Question 4. Question : A physician is called to the intensive care unit to provide care for a patient who received second and third degree burns over 50 percent of his body due to a chemical fire. The patient is in respiratory distress and is suffering from severe dehydration. The physician provides support for two hours. Later that day, the physician returns and provides an additional hour of critical care support to the patient.

Question 5. Question : A patient was in the delivery room ready to give birth. When the physician had the patient start pushing, possible complications for the infant were noted and the hospital pediatric neonatal specialist was notified of a possible need for her evaluation of this newborn. The pediatric specialist was notified at 9:20 am. At 10 am, she was informed via phone call from the OB/GYN that the infant had normal Apgar scores of 9 and 9.

Question 6. Question : A new patient diagnosed with mild intellectual disabilities and self-abuse is sent to a custodial care facility for admission. The patient’s family is no longer able to care for the patient at home. The care facility physician documents a problem focused history with a problem focused exam. The medical decision making documented was straightforward.

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Question 7. Question : A 4-year-old female established patient received Evaluation and Management services, which included a problem focused history, an expanded problem focused exam, and medical decision making (MDM) of a low level. The patient is diagnosed with influenza.

Question 8. Question : A 75-year-old patient was just diagnosed with type 1 diabetes. This means that the patient will have to give himself insulin shots. The physician supervised the coordination of home health care, which required 30 minutes of his time.

Question 9. Question : A physician called an established patient to inform her that the results of a chest x-ray were negative. The call was 5 minutes in duration. The patient had previously been seen in the office 10 days ago.

Question 10. Question : Subsequent follow-up care is provided for a comatose patient transferred to a long-term care center from the hospital two days ago. The resident shows no signs of consciousness on examination but appears to have developed a minor upper respiratory tract infection with a fever and rales heard on auscultation. The physician performs an expanded problem focused history and a problem focused interval examination with respiratory status and status of related organ systems such as cardiovascular. The physician is concerned that the respiratory infection could progress to pneumonia and orders the appropriate treatment. The MDM complexity is moderate.Case Study: A 64-year-old female patient with diabetes

 

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diabetes in old age

Introduction

Diabetes is a condition that affects your body’s ability to use insulin. Insulin helps your body break down sugar into energy and uses it when you need it. If there isn’t enough insulin available, the body cannot properly process sugar and this can lead to high blood sugar levels. Type-2 diabetes (also known as adult onset or late onset diabetes) is a form of diabetes in which the pancreas either doesn’t make enough insulin or doesn’t respond well when it does produce some. In type-1 diabetes (also known as juvenile onset or early onset), one’s own immune system destroys cells containing beta cells that release insulin into the bloodstream — these are called “islets” within the pancreas

Type-2 diabetes is associated with older age, making it common in people 65 and older.

• Diabetes is a disease that affects the body’s ability to produce or respond to insulin, which is a hormone produced by the pancreas.

• Type 2 diabetes is the most common form of diabetes and it occurs when your body doesn’t make enough insulin or doesn’t use it effectively. This can happen because you have too much glucose (sugar) in your blood after eating; you’re overweight; or you have other conditions that impact how well your body uses glucose for energy.

• Type 2 diabetes is associated with older age, making it common in people 65 and older

With type-2 diabetes, the pancreas either doesn’t make enough insulin to get the job done or the cells don’t respond well to what insulin is available.

Type-2 diabetes is a condition caused by long-term exposure to high levels of glucose in your blood. The pancreas either doesn’t make enough insulin to get the job done or the cells don’t respond well to what insulin is available. Either way, this leads to high levels of glucose in your bloodstream.

Insulin acts like a key that unlocks doors for glucose (sugar). When you eat, carbohydrates are broken down into smaller units called glucose molecules; these enter cells and become fuel for energy production. Insulin helps move these glucose molecules from where they’re stored in your muscles and liver toward tissues such as brain cells, heart muscle tissue and skeletal muscle fibers where they can be used as ATP — the body’s main source of energy

When diabetes is well managed, seniors can live a long, healthy life

When diabetes is well managed, seniors can live a long, healthy life. In fact, more than half of people with diabetes will be able to lead normal lives throughout their senior years.

With proper treatment and lifestyle changes, it’s possible to manage your diabetes so that it doesn’t prevent you from enjoying the things that matter most: living independently in your own home; being active; spending time with family and friends; doing what makes you happy—and yes, even getting some sleep!

Diabetes management includes regular visits to your healthcare provider for testing and monitoring blood sugar levels as well as lifestyle changes such as exercising every day and eating a balanced diet.

Diabetes management includes regular visits to your healthcare provider for testing and monitoring blood sugar levels as well as lifestyle changes such as exercising every day and eating a balanced diet.

The importance of exercise cannot be overstated when it comes to managing diabetes. Exercise improves your overall health by helping you to lose weight, reduce your risk of heart disease and stroke, boost moods, sleep better at night (which can improve energy levels), lower blood pressure in those with hypertension or high cholesterol numbers; decrease stress levels; lower blood sugars; increase feelings of relaxation which can help prevent depression or anxiety disorders like bipolar disorder which often develops with this disease due to the stressors associated with it!

A healthy diet is also important because it gives us nutrients that our bodies need but often times don’t get enough from food alone – especially if we’re not following proper meal plan guidelines set forth by our doctors’ offices/hospitals.”

A maintenance plan that includes both long- and short-term goals can help you manage your diabetes effectively.

Long-term goals are the big picture. They’re things you want to accomplish over the course of your life, like getting married, having children and retiring comfortably. Short-term goals are smaller steps you can take toward those longer-term ones: lose 10 pounds; get up early every day; eat healthier foods at home instead of relying on fast food at work.*

Short term success is important because it builds momentum toward your long-term goal—and also because it gives you something tangible to shoot for when it comes time to check in with your doctor or dietitian. Achieving short-term goals makes meeting intermediate steps easier than trying for a distant horizon (e.g., losing 100 pounds).

Seniors with diabetes are at risk of heart disease, vision loss and nerve damage — all conditions that can be limited or prevented by controlling your blood sugar level.

Diabetes is a condition that occurs when the body doesn’t produce enough insulin or doesn’t use it properly. Insulin helps your body convert sugar into energy. If you have diabetes, your blood sugar level is too high because there’s not enough insulin in your system to keep it balanced.

Diabetes can lead to heart disease, vision loss and nerve damage — all conditions that can be limited or prevented by controlling your blood sugar level. The good news is: managing type 2 diabetes through lifestyle changes such as diet and exercise are effective treatments for this condition.

And if you’re taking medication for high blood pressure (hypertension), high cholesterol (cholesterol), heart failure or kidney disease? Medication may also help lower triglycerides in some older adults with type 2 diabetes who don’t respond well to diet alone

Diabetes is complicated but it is manageable through appropriate treatment.

Diabetes is a chronic disease that requires long-term treatment to achieve good control of blood glucose levels. This can be done through lifestyle changes, medications and diet, exercise and medication.

Lifestyle changes are important in managing diabetes because they help to reduce your risk of complications by helping you stay away from weight gain and high cholesterol levels while reducing the risk of heart attack or stroke. These include:

• Limiting alcohol intake – Alcohol is not recommended for people with diabetes because it may increase the risk of hypoglycemia (low blood sugar) during sleep – this can lead to serious health problems such as coma or death if left unchecked for too long without treatment;

• Limiting salt intake – People with type 2 diabetes should limit their sodium intake, which is found naturally in foods like vegetables but also processed foods such as meats;

• Keeping a normal body weight – People who have been diagnosed with type 2 diabetes should aim for losing no more than 1-2 pounds per week until they reach their target weight goal;

• Exercising regularly – Regular physical activity such as walking every day helps keep cholesterol levels down slightly while increasing insulin sensitivity at the same time making it easier for muscles cells process glucose properly thus reducing insulin resistance over time;

Conclusion

Diabetic management is complex, but there are many things you can do to improve your health. Lifestyle changes and medication can help you control diabetes and prevent serious complications. When it comes to managing your diabetes, a regular visit with your provider is the best way to stay on top of your care.