Hypertension with T2 DM
A 60 year old female presented to OPD with complaints of weakness for past few days. She is also complaining of vertigo and she also adds she gets headache upon waking up. She says she wakes up with a headache, and has to take paracetamol 500mg for quite a long time. History Known case of DM on OAD Vitals BP - 140/90 Pulse - 90/min RBS - 201mg/dl Investigations CBC - WNL TYPHI DOT - Negative Diagnosis HTN with T2DM Management I have started her on Telmisartan plus Chlorthiadone combination, and Vertin 16mg BD She is already taking - Tab Metformin 500mg SR BD I had followed her up after two days, but she says she still has a bit vertigo and weakness too Kindly give your opinion on this case.
UNCONTROLLED DIABETES WITH.. HT.. WITH..VERTIGO.. ? ( BPPV ) .. NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. CERVICAL SPINE X-RAY STUDY.. CTCE STUDY BRAIN.. NEED'S.. STRICT GLYCEMIC CONTROL WITH ANTIDIABETIC MANAGEMENT WITH EXPERTS OPINION.. HT..TELMISARTAN + CHLORTHIADONE.. MULTIVITAMINS ANTIOXIDANTS..
Screening for CoViD-19. Recent reports suggest that vertigo is also a symptom of nCoViD-19.
As patient is diabetic in which diuresis is common and also complaining of weakness-- Chlorthalidone will increase her weakness and diuresis .. Get her CBC done to rule out anaemia KFT done to rule out diabetic nephropathy S.Vitamin - D levels done and correct vitamin D deficiency , if any . Vertigo and headache can be due to BPPV , Migraine or cervical spondylitis. Also keep COVID-19 in mind
Vertigo can be due to BPPV or labyrinthintis Or may be due to stress and anxiety Give TCA tri cyclic antidepressants or SSRI As with betahistine patient not improving Advise MR angio of brain as she is known case of DM and HTN
U can start him ecosprin av what is pt bp.if headache is chronic better fo ct
BPPV
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