Problem
Ms. A presents with complaints of headache and general fatigue. She also reports that she has had periodic nosebleeds. She reported that she has been taking many medications for her hypertension in the past, but stopped taking them because of the side effects. She could not recall the names of the medications. Prescribed one year ago and currently taking 100 mg/day atenolol and 12.5 mg/day hydrochlorothiazide (HCTZ), which she admits to taking irregularly because "... they bother me, and I forget to renew my prescription." Despite this antihypertensive regimen, her blood pressure remains elevated, ranging from 150 to 155/110 to 114 mm Hg. In addition, Ms. A admits that she has found it difficult to exercise, stop smoking, and change her eating habits. She has not seen her primary care doctor in a year. Smokes 15 cigarettes a day for 10 years.
Task
A. What body exams would you assess?
B. What differential diagnoses would you list?
C. What tests would you order and evaluate?
D. What are the final diagnoses?
E. What is the treatment plan?