We start our case with a Male, Age 56 who for the past two months has been having episodes forgetful of speech and vision dimness that last about two minutes. During this time he stopped taking his Zestril (lisinopril) prescribed for hypertension because he thought it was causing him to have anxiety or orthostatic hypotension. In addition, he started taking Inderal (propranolol, purchased over the Internet) every morning before class to reduce his “anxiety” while speaking. Today his episode lasted almost 10 minutes. He also reports that he has not been taking his Lipitor (atorvastatin) prescribed for high cholesterol over the past month because he says "I 've been following my diabetic diet" for pre-type II diabetes diagnosed six months ago. Further history and labs are
• Smoker: 1 pack/day • Height: 5 '11" • Weight: 195 lbs.
• Glucose: (4 hours post-prandial) 165 mg.dL • HbA1c: 10.4
• BP: 156/94 • Resting Pulse: 52 • LDL Cholesterol: 175 mg/dL
What problem caused the professor 's symptoms?
The presentation of symptoms that the professor is experiencing suggest that the professor is having a transient ischemic attack or TIA. A TIA is a recurrent episode of neurologic deficit, lasting seconds to hours that …show more content…
The beta blocker reduced his perceived anxiety during class because it blocks the ability of epinephrine to stimulate the Beta 2 receptors on the heart. As a result his pulse was reduced and he had less of a sense of fright or flight. Beta blockers will also reduce blood pressure for short periods of time. He might be prescribed a beta blocker as part of his treatment regimen and will be warned about purchasing prescriptions over the Internet. He will be told to monitor his pulse at home, to rise slowly after sitting for long periods of time, and to drink plenty of
• Smoker: 1 pack/day • Height: 5 '11" • Weight: 195 lbs.
• Glucose: (4 hours post-prandial) 165 mg.dL • HbA1c: 10.4
• BP: 156/94 • Resting Pulse: 52 • LDL Cholesterol: 175 mg/dL
What problem caused the professor 's symptoms?
The presentation of symptoms that the professor is experiencing suggest that the professor is having a transient ischemic attack or TIA. A TIA is a recurrent episode of neurologic deficit, lasting seconds to hours that …show more content…
The beta blocker reduced his perceived anxiety during class because it blocks the ability of epinephrine to stimulate the Beta 2 receptors on the heart. As a result his pulse was reduced and he had less of a sense of fright or flight. Beta blockers will also reduce blood pressure for short periods of time. He might be prescribed a beta blocker as part of his treatment regimen and will be warned about purchasing prescriptions over the Internet. He will be told to monitor his pulse at home, to rise slowly after sitting for long periods of time, and to drink plenty of