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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