(Shelf) Journal

Question 1

Patient is a diabetic with hypertension + evidence of nephropathy based on a urine dipstick showing 1+ protein

1st line anti-hypertensive?

Answer 1

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

Question 2

60 y.o. Diabetic with no vaccinations in the last 10 years

Which 3 vaccines is he due for?

Answer 2

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