ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 177
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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The double burden of disease: A case of pulmonary
tuberculosis and metabolic syndrome in a woman with an
intracranial mass
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Dr Dena Mae Amor Desabille-Deblois1,2
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Philippine General Hospital Department of Family and Community Medicine, 2Philippine Academy of
Family Physicians
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The clinical case discussion aims to discuss the approach to diagnosis and management of a patient
with communicable and non-communicable comorbidities and to apply patient-centred care in
decision making for the appropriate preventive and curative care. It also aims to provide an avenue for
healthy discourse in improving the quality of service for patients and their families through the practice
of primary care.
This is about a 49-year-old female, known diabetic with cough and colds for seven months. She was
seen in two different local clinics prior to consultation at the family practice centre of a tertiary hospital
in the Philippines. She had no prior COVID vaccination, no history of tuberculosis treatment, with a 32year history of second-hand smoke exposure and a four-year history of biofuel smoke exposure. On
physical examination, she had elevated blood pressure at 150/100 mmHg, right eye ptosis and down
and out deviation of the eye, with clear breath sounds and hyperpigmented lesions on bilateral legs;
other findings were unremarkable. Her highest education attainment is Grade 2 level, she is able to
read and write basic words and has limited financial capacity as a family. She also had an emotionally
critical misperception regarding COVID vaccination. She was diagnosed with drug-sensitive pulmonary
tuberculosis, bacteriologically confirmed, new, and metabolic syndrome that consisted of diabetes
mellitus, type 2, non-obese, insulin-requiring, uncontrolled, with peripheral neuropathy, hypertension,
newly diagnosed, dyslipidaemia with an elevated total cholesterol, low-density lipoprotein, low highdensity lipoprotein, central obesity and a family diagnosis of nuclear family in the illness trajectory of
reaction to diagnosis.
The goals of management were the identification of the underlying cause of the patient’s cough and its
related symptoms, control of comorbidities and diagnose other co-existing conditions and exploration
of the family’s and the community’s resources for the double burden of communicable and noncommunicable diseases.
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