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Case Study

question 20

Multiple Choice

Case Study

 WD is an 86 yo F who is seen by the internal medicine physician because she has been feeling very depressed. The physician takes a full history from WD, which reveals that several medications have been prescribed to her by a variety of specialists. It seems that each specialist neglected to pay attention to the meds that WD was prescribed by her other doctors and the potential drug-nutrient interactions.
 The physician’s notes are as follows:
 Current Medication  Reason for Prescribing
 St. John’s wort  WD read in a magazine that this helps with depression
 Slow Fe (iron supplement)  prior anemia
 Warfarin  history of embolic stroke
 Omeprazole  history of embolic stroke
 Tums  upset stomach
 Amoxicillin recent respiratory infection
 Doxazosin  incontinence
 Allegra  seasonal allergies
 Lipitor  high cholesterol
 Vitamin E  she heard it was “good for heart disease”
 Diet hx
 B- eggs  D- cooked spinach
 bacon  chicken breast
 orange juice  mashed potatoes
 fruit cocktail  
 L- Italian hoagie (salami, ham, cheddar cheese, lettuce, and tomato) iced tea

-The doctor is concerned about potential drug-nutrient interactions as a consequence of WD taking Allegra and Lipitor He consults the registered dietitian to have a look at WD's diet Which of the following in her diet history is of concern?


Definitions:

Income Inequality

The unequal distribution of income among individuals or households within a society or country.

Technological Change

Innovations or improvements in technology that enhance productivity or efficiency in the production of goods and services.

Negative Income Tax

A welfare system within which individuals earning below a certain amount receive supplemental pay from the government instead of paying taxes.

Rawlsian

Pertaining to the philosophical and ethical framework proposed by John Rawls, focusing on justice as fairness and the distribution of resources.

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