Mrs Donovan is a 58-year-old who works as an administrative assistant at a state university after
obtaining her bachelors degree 35 years ago. Her BMI is 34kg/m2 (moderately obese), diabetic.
hypertension, and has artherosclerosis. She has been managing these conditions poorly for the
past 4 years because of her extreme dedication to work. She is a heavy smoker and drinks
alcohol. Mrs Donovan experienced an inferior myocardial infarction about 4 months ago;
however, she went through intensive cardiac rehabilitation. Despite the rehabilitation she
sustained a residual complications. She has since been having increasing fatigue,
bilateral leg swelling, swelling of the abdomen, easy satiety from eating, reduced
appetite, and palpitations (awareness of heart beats). Her physician recently told her
that she has a liver enlargement during her last visit. She admits to drinking too much
alcohol since her discharge from the hospital to cope with stress and not taking her medications
as prescribed.
What are Mrs Donovan's symptoms indicative of? i.e., possible diagnosis (10)
Explain the pathophysiology of his condition (25) - i.e., describe the mechanism of how
the diagnosis leads to the symptoms described above.
What factor(s) contributed to his new symptoms? (5)
List TWO important diagnostic tests that Mr. Richard would benefit from (5)
What kind of advice would Mr. Richard benefit from? (5)
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