Mariselle is a 42-year-old woman that visits your clinic for aroutine appointment. Two years ago, she was diagnosed with earlystage (3a) chronic kidney disease associated with hypertension. Herkidney disease and hypertension are managed by a combination ofdrugs that includes an ACE inhibitor, and dietary restriction.Mariselle is complaining of ‘the heads of mine’ that she says makeher feel poorly, and a discomfort in her back and abdomen Shereports eating fast food for the last two weeks because she was tootired to cook at home.
Medical History
Her notes show that a previous doctor has prescribed Marisellebenzodiazepines for nervous complaints. You have treated her motherin the past for depression.
On examination
Mariselle describes her symptoms in a flat, monotonous voice andlooks anxious and ill at ease. You find that she uses vague phrasessuch as ‘these heads of mine’ without properly describing them.During the consultation, she attributes her symptoms to her chronickidney disease. Further exploration reveals that Mariselle isdescribing headaches which she attributes to her kidneyproblems.
Questions:
- Identify both the diagnosis and the prognosis of your patient,and explain the difference between these two
