Obesity Case Study (Cholelithiasis) – What is Mrs AC’s BMI and discuss how this is determined…

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Instruction:

It has a strict limit of 1000 words, not including any inserted items (table, diagrams) or references, and please use using various sources (i.e. not just text books, but also journal articles). .

Case study:

Mrs AC is a 38 year old female, who used to work in a catering business as a chef. She calls into your pharmacy regularly for her medication but has increasingly become aware of her weight problem affecting her mobility. She notices that you have a range of information and support material regarding this condition and asks for assistance.

On examination: Weight 113kg; Height 1.62m

Social history: Married with 2 children; Smoker; Obese

Past medical history: Diabetes; Osteoarthritis

Current Medications: Microgynon 50®; Fenofibrate; Celecoxib; Metformin

Elevated triglycerides: 159 mg/dL (40 to 150 mg/dL)

Questions:

  1. What is Mrs AC’s BMI and discuss how this is determined and what health risks are associated with obesity?
  1. What dietary advice can you offer Mrs AC to assist her with her condition?
  1. Discuss what therapeutic options could be considered for Mrs AC’s weight problem and their respective benefits along with any practical issues.
  1. A few months later Mrs AC presents to the ED with right upper quadrant pain radiating to the right shoulder, it appears to be increasing in severity and she is also complaining of nausea. Other episodes have resolved after about 60 minutes or so. Her weight is now 77kg as she has recently been a contestant on a TV reality program where she lost 36kg over 12 weeks. The following investigations were noted:

LFTs:  

Bilirubin normal

Alkaline Phosphatase 350 U/L (25 to 100u/L)

Aspartate Aminotransferase (AST) 50u/L (5-45u/L)

Alanine Aminotransferase (ALT) 60u/L (< 36 u/L)

  1. What could Mrs AC’s presenting condition be and what other factors could be involved knowing her medication profile?
  1. What therapy could have been considered for Mrs AC to reduce the risk of developing gall stones?
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