Some help from those who know English.
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Hi everybody. I am trying to make some tasks for international students, so, if you will, could you guys please check weather those tasks sound like English language? Please be sure to comment if anything sounds weird or unnatural.
11.) A 42-year-old Caucasian man comes in for an advice. He says that a year ago he decided to change his lifestyle to prevent heart diseases, because his blood pressure level was up to 165/102, and his BMI was 28,3. He started to follow a healthy diet, increased his physical activity to 45 minutes 5 times a week and started visiting gym twice a week. He does not smoke. His BMI decreased to 23.2 and blood pressure reduced to 150/95 on average and remains at this level during last 6 months. He has no complaints and says that he feels well, but he wants to know if anything should be done about his blood pressure. He has no problems in his family history and past medical history. Physical examination reveals a temperature of 36.8 C, blood pressure of 147/96, pulse of 68/min, and respiratory rate of 16/min. Lungs are clear to auscultation. Cardiac and abdominal examination is within normal limits. Blood chemistry, including glucose, is within normal limits, his cholesterol is 4.7, LDL is 2.6, HDL is 1.24 mmol/L. Urinalysis and ACR are normal.
What is the diagnosis? What is your advice in this case?12.) A 52-year-old white man is brought in for a physical examination by his wife. She states that she occasionally checks his blood pressure during last 2 years and numbers range from 160/90 to 175/100. She says he smokes 5-10 cigarettes per day, drinks about 7-10 drinks per week. After asked about family history he said that his father had suffered myocardial infarction at the age of 72. Physical examination reveals a temperature of 36.8 C (98.3 F), blood pressure of 170/100 mm Hg, pulse of 76/min, and respiratory rate of 16/min. Lungs are clear to auscultation. Cardiac examination is within normal limits. He did some laboratory tests 2 days ago. Blood chemistry, including potassium, CK, creatinine, ALT, AST is within normal limits, his lipid profile: total cholesterol – 7.2, LDL – 5.0,HDL – 1.2 mmol/L, his serum glucose is 6.4. His urinalysis, including microscopy, is normal. ECG shows no abnormality.
What is the diagnosis and treatment of this patient?13.) A 57 -year-old woman comes complaining of her blood pressure. She says that she regularly measures her blood pressure and numbers usually are around 160/100 and sometimes up to 170/100. She denies smoking and alcohol use. She takes aspirin 100 mg and amlodipine 10 mg.
On physical examination her blood pressure is 162/98 mm Hg, temperature is 36.8 C (98.3 F), heart rate is 80/min, and respiratory rate is 16/min. Lungs are clear. Cardiac and abdominal examination is within normal limits. Her BMI is 32,1 and her waist circumference is 92 cm. She also did some tests before her visit: blood chemistry is normal, lipid profile: total cholesterol – 5.82, LDL – 3.16, HDL – 1.34 mmol/L, fasting serum glucose is 7.4 mmol/L, 3 weeks ago her fasting serum glucose was 7.5 mmol/L. Her ACR is done and is 3.2 mg/µmol/L.
What’s the most likely diagnosis?
What, if any, additional drug(s) should be given in this case?14.) A 75-year-old-man residing in rural area comes in for periodic health examination. He hasn’t been to doctor for 2 years already. He complains of a chest pain that appears on severe physical exertion(when he cuts logs for a prolonged period of time), which radiates to his left arm and ends within 1 minute or less after the activity is stopped. Ordinary physical activity, like walking, does not cause any problems(he often goes fishing and walks up to 2 kilometers without stopping). In general, he leads a healthy lifestyle, he has never smoked, he does not drink alcohol, walks a mile almost every day, frequently takes short bike rides and does other physical activities. He says that 2 years ago he was taken to hospital because of changes on his ECG(that was taken routinely) with suspection to having “small” myocardial infarction(though diagnosis was not confirmed) and was discharged within 9 days and was prescribed a “bunch of pills”, but he gave up taking them soon because he was feeling well. He didn’t want to come to the doctor, but his wife insisted.
On physical his temperature is 36.8 C, blood pressure is 170/92 mm Hg, pulse is 56/min, and respiratory rate is 16/min. Lungs are clear to auscultation. Cardiac examination reveals no significant findings, no oedema is observed. ECG shows sinus rhythm, 55/min and no signs of ischemia. Blood chemistry, including potassium, CK, creatinine, ALT, AST is within normal limits, lipid profile: total cholesterol – 4.5, LDL – 2.3, HDL – 1.1 mmol/L, his serum glucose is 5.6. His urinalysis, including microscopy, is normal. Her BMI is 22.8.
What is the diagnosis and what should be(if should be) prescribed in this case?- A 62-year-old man comes for follow-up. He complains of retrosternal pain that appears on moderate exertion, like walking 2-3 blocks or climbing couple of flights of stairs. He says that pain is relieved very fast by discontinuing physical activity and taking nitroglycerin spray.
He was a heavy smoker with a history of 32 pack-years, but quit smoking and alcohol after he suffered myocardial infarction 3 months ago.
On physical examination his temperature is 36.8 C, blood pressure is 156/92 mm Hg, pulse is 74/min, and respiratory rate is 16/min. Lungs are clear to auscultation. Cardiac examination reveals no significant findings, no oedema is observed. ECG shows postinfarctional changes. His BMI is 31.2. His blood chemistry taken 3 days ago is within normal limits, lipid profile: total cholesterol – 5.08, LDL – 2.32, HDL – 1.14 mmol/L, TG – 1.17, his serum glucose is 5.7. His urinalysis, including microscopy, and CBC are normal. He is on enalapril 10 mg a day, bisoprolol 2.5 mg, atorvastatin 10 mg, he’s been taking these medication for 3 months already, he used to take aspirin, but decided to stop because of epigastrial pain and discomfort, that disappeared every time he stopped taking aspirin, and reappeared 1-2 weeks after he restarted taking it and that happened several times.
What’s the diagnosis and what will be your recommendations?
16.)A 53-year-old woman comes complaining of a “tight” retrosternal pain that appears on moderate exertion(she lives on the second floor and not that rarely has to stop while walking stairs). When she stops the pain goes away in less than a minute. She tried taking nitroglycerine, but she feels dizzy after it and it causes headache, so she stopped. She says that the same pain also sometimes appears during emotional stress.
Her PMH and family history reveal that her mother suffered myocardial infarction at 78. On physical examination her temperature is 36.7 C, blood pressure is 110/62 mm Hg, pulse is 54/min, and respiratory rate is 17/min. Lungs are clear. Cardiac and abdominal examinations reveal no abnormalities, ECG shows sinus rhythm, 53bpm. Holter ECG was recently performed and shows periodic ST elevations for more than 1-2 minutes that correlate with physical activity in her Holter diary. Her BMI is 23.2.
Her lipid profile: total cholesterol – 4.48, LDL – 2.32, HDL – 1.24 mmol/L, TG – 0.97, her serum glucose is 5.5, the rest of biochemistry is normal. Her urinalysis, including microscopy, and CBC are normal. She takes nothing.
What’s the diagnosis and treatment(if any needed)? - A 62-year-old man comes for follow-up. He complains of retrosternal pain that appears on moderate exertion, like walking 2-3 blocks or climbing couple of flights of stairs. He says that pain is relieved very fast by discontinuing physical activity and taking nitroglycerin spray.
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Assuming this has been copied directly and is not just a transcribing error, there should be a space before opening parentheses and you’ve missed a couple of decimal points (“BMI was 28,3” in 11 and “BMI is 32,1” in 13). I would use “advice” rather than “an advice” and “visiting the gym” rather than “visiting gym”, but that could just be me. Nothing else stood out (well, “what should be (if should be)” could perhaps be “what (if anything) should be”).