Patient is a diabetic with hypertension + evidence of nephropathy based on a urine dipstick showing 1+ protein
1st line anti-hypertensive?
ACE inhibitor such as lisinopril
ACE inhibitors result in the dilation of the nephron’s efferent arterioles → decreasing filtration pressure, and preventing the progression of diabetic nephropathy
60 y.o. Diabetic with no vaccinations in the last 10 years
Which 3 vaccines is he due for?
Pneumovax + tetanus + flu
The patient is due for Pneumovax and a yearly flu shot because of the immunosuppessive effect of diabetes. He is also due for a tetanus because as noted in the vignette it has been over 10 years since he has had any vaccinations