Ipp 2

Presentation: IPP2
student name: Manar Khaled Al-

Zahrani.
ID: 220016729.
preceptor: Mohammed alhuthayfi.
Period: first month .
Case report
Chief Complaint:
He said “Some time i have left side weakness and chest discomfort”.
HPI:
Pt is a 43-year-old male who presented to a healthcare provider on 13/07/2023
with complaints of increasing left side weakness, chest discomfort, and sudden
numbness that goes and comes back at the same time.
PMH : Hypertension.
SH: He is smoker.
FH: Not mentioned
Meds: Amodip (Amlodipine) 5mg OD ,Ivarin (Rosuvastatin)
10mg OD, Cardicor (Bisoprolol) 5mg OD, Micardis
(Telmisartan) 80mg OD
All: No known drug allergy

ROS: Look conscious.
Physical Examination:
Gen: A 43-year-old, male
VS: BP 199/108 mm Hg, P 74 bpm , T 37 C, Ht 165 cm(1.65m), Wt
75.5 kg
Skin: normal , HEENT: normal , Lungs/Thorax:normal
CV(heart): normal, Abdomen:normal , Extremities:normal

Neuro: normal
Lab results
Pt lab results Normal lab results
WBC 6,28 × 109/L 4.5 to 11.0 × 109/L
Hb 18.40 g/dl 12 to 16 g/dl
Plt 265 × 109/L 150 to 400 × 109/L
MCV 90,20 fL 80 to 100 fL
Glu 4.68 3.9 to 6.1mmol/L
Na 137 135 to 145 mEQ/L
K 4.30 3.5 to 5.5 mEq/L
Cl 104 96 to 106 mEq/L
BUN 19 7 - 20 mg/dL
Scr 71 μmol/L (or 0.8 mg/dl) to 106 μmol/L(or 0.6 to 1.2 53

mg/dl)
Subjective
Chief Complaint:
He said “Some time i have left side weakness and chest discomfort”.
HPI:
Pt is a 43-year-old male who presented to a healthcare provider on 13/07/2023
with complaints of increasing left side weakness, chest discomfort, and sudden
numbness that goes and comes back at the same time.
PMH : Hypertension.
SH: He is smoker.
FH: Not mentioned
Meds: Amodip (Amlodipine) 5mg OD ,Ivarin (Rosuvastatin)
10mg OD, Cardicor (Bisoprolol) 5mg OD, Micardis
(Telmisartan) 80mg OD
All: No known drug allergy

ROS: Look conscious.
Objective
Physical Examination:
Gen: A 43-year-old, male
VS: BP 199/108 mm Hg, P 74 bpm , T 37 C, Ht 165 cm(1.65m), Wt
75.5 kg
Skin: normal , HEENT: normal , Lungs/Thorax:normal
CV(heart): normal, Abdomen:normal , Extremities:normal

Neuro: normal
Lab results
Pt lab results Normal lab results
WBC 6,28 × 109/L 4.5 to 11.0 × 109/L
Hb 18.40 g/dl 12 to 16 g/dl
Plt 265 × 109/L 150 to 400 × 109/L
MCV 90,20 fL 80 to 100 fL
Glu 4.68 3.9 to 6.1mmol/L
Na 137 135 to 145 mEQ/L
K 4.30 3.5 to 5.5 mEq/L
Cl 104 96 to 106 mEq/L
BUN 19 7 - 20 mg/dL
Scr 71
Assessment
Caculatios:
 BMI= 75.5/1,65m2=27.7 kg
 CrCl= (140-age)*wight /72*Scr= (140-43)* 75.5
/72*1,65 =127 mL/min
Diagnosis
HTN urgency Transient Ischemic Attack

Bb=199/108 (TIA):
Subjective:
1. increasing left side weakness.
2. chest discomfort.
3. sudden numbness.
Risk factor
o Smoking is risk factor for both TIA and HTN

o High Bb is risk factor for TIA
o Age greater than 40 years is risk factor for TIA
Treatment optienos
Uncontrolled HTN (TIA)
ACE inhibitor Aspirin
Statin
ARBs
B- blocker Blood thinners
CCB HTN medications

Plan
Short-terms Goals:
Relieve the symptoms the patient suffering
from.
Long-terms Goals:
:Goals Reduce mortality
To correct the TIA and

prevent a stroke
Controlled HTN and decrease it

by 130/<80 mmHg
Non Pharmacological
01 Smoking
Cessation
02 Low Na diet
Physical activity 30-60 Minutes

03 daily
Pharmacological treatment
Amodip Cardicor Aspilo (Aspirin) 81

(Amlodipine) (Bisoprolol) mg OD + omepral
(omeprazole|) 20mg
5mg BID 5mg BID OD
HTN HTN HTN TIA TIA

Micardis Ivarin
(Telmisartan) (Rosuvastatin
80mg OD ) 20mg OD
Monitoring
monitoring the ECG for TIA

Vitul signs Serum K
S.E of drugs
Aspirin bleeding Telmisartan can

Bb, HR, TEM.
Statin  muscle pain. increase your
potassium levels
Patient education:
 Take omeprazole before food.
 If you have muscles pain or bleeding or swelling go to your
doctor.
 Do not duplicate the doses.
 Remember to take your medication at their time.
 Go to the doctor if you experience any complications.
 Visit your doctor periodically.
Month report
in the beginning, I was in the Outpatient, and I learned
how to calculate the dose of paracetamol and iron for
children, as well as the dose of amoxicillin. I used to start
4/7/2023 - at 8 am and finish at 2:30 pm. I start by taking the patient
13/7/2023 file number and inserting it into the computer then
Searching for their order and then print the order for the
same day date and after that I go to prepare the
medication in order and labeling it, and then dispensing it
sometimes if the doctor allowed me.
After that, I moved to the Inpatient, and there was not
much difference, except that we did not deal directly with
patients except rarely. Most of the dealings were with
16/7/2023-
medicine trollies that we had to prepare before 12 pm. We
23/7/2023
were completing everything at that time. From the most
prescribed drug in Inpatient is ceftriaxone 1g inj vial from
cephalosporin antibiotic, because they were used before
operations to avoid infections.
After that, I moved to the IV room. It was very pleasant.
The work time is deferent I in it, as I start at 10 am And
finish at 5:35 or 6 PM as a maximum. I learned to calculate
many equations, including NaCl, NaPo4, Ca Glu, KCl,
24/7/2023 - amino acid, and MgSo4 . It was easy as I start with the
31/7/2023 calculation and then give it to the doctor to checked after
me to make sure. I already prepared dome IV fluid and TPN
for pediatric with one of stuff supervision. For example: I
prepared Amphotericin, heparin, and tuberculin test
preparation.
Finally, I would like to mention how much the stuff in KFH
were cooperative with me in learning and they were very
good with dealing with each other , Also communication
with the doctors responsible for IPP2 training at the
university was also easy and fast, which made it easy for me
to always get answers to my questions.
Thanks

Ipp 2

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Ipp 2

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Presentation: IPP2

student name: Manar Khaled Al-

All: No known drug allergy

Skin: normal , HEENT: normal , Lungs/Thorax:normal

CV(heart): normal, Abdomen:normal , Extremities:normal

Hb 18.40 g/dl 12 to 16 g/dl

Plt 265 × 109/L 150 to 400 × 109/L

MCV 90,20 fL 80 to 100 fL

Glu 4.68 3.9 to 6.1mmol/L

Na 137 135 to 145 mEQ/L

K 4.30 3.5 to 5.5 mEq/L

Cl 104 96 to 106 mEq/L

Scr 71 μmol/L (or 0.8 mg/dl) to 106 μmol/L(or 0.6 to 1.2 53

All: No known drug allergy

Skin: normal , HEENT: normal , Lungs/Thorax:normal

CV(heart): normal, Abdomen:normal , Extremities:normal

Hb 18.40 g/dl 12 to 16 g/dl

Plt 265 × 109/L 150 to 400 × 109/L

MCV 90,20 fL 80 to 100 fL

Glu 4.68 3.9 to 6.1mmol/L

Na 137 135 to 145 mEQ/L

K 4.30 3.5 to 5.5 mEq/L

Cl 104 96 to 106 mEq/L

HTN urgency Transient Ischemic Attack

o Smoking is risk factor for both TIA and HTN

ACE inhibitor Aspirin

B- blocker Blood thinners

CCB HTN medications

To correct the TIA and

Controlled HTN and decrease it

Physical activity 30-60 Minutes

Amodip Cardicor Aspilo (Aspirin) 81

HTN HTN HTN TIA TIA

monitoring the ECG for TIA

Aspirin bleeding Telmisartan can

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