1. Mr. Brown, a 72 year old farmer, lives alone on a fixed income. He went to this physician complaining of being tired all of the time. His diet consists primarily of tea and toast. Blood work reveals his hemoglobin is 90, his hematocrit is .97 and he has a white blood cell count of 9 with a normal differential. His platelets are 300. No other manifestations are noted.

Normal values;

hemoglobin-140-180 g/L

haematocrit - .400- .540 L/L

leukocytes- .4  - .11 X 10 E^9/L

platelets-150-400 X 10 E^9/L

Question:

What is the cause of the fatigue?

A. Older age: Aging is a well-established risk factor for hypertension due to decreased arterial elasticity and increased peripheral vascular resistance. Blood vessels stiffen over time, contributing to elevated blood pressure.

B. Obesity: Excess body weight increases cardiac output and peripheral resistance, both of which contribute to the development of hypertension. Adipose tissue also affects hormonal regulation of blood pressure.

C. Alcoholism: Chronic excessive alcohol consumption can raise blood pressure by stimulating the sympathetic nervous system and affecting vascular tone. It is a recognized modifiable risk factor for hypertension.

D. High fat diet: While a diet high in saturated fats contributes to atherosclerosis and cardiovascular disease, it is not directly linked to the development of hypertension. Sodium intake and overall caloric excess are more closely associated with blood pressure elevation.

E. Genetics: Family history and genetic predisposition play a significant role in the risk of developing hypertension. Genetic factors can influence vascular tone, renal sodium handling, and hormonal regulation of blood pressure.

A. Crepitus: Crepitus refers to a grating or crackling sensation felt or heard with joint movement, often associated with fractures or degenerative joint disease. It can occur with cartilage damage but does not specifically indicate that a joint is dislocated. Crepitus alone is not a definitive sign of joint displacement.

B. Deformity of a joint: A visible or palpable deformity is a hallmark sign of joint dislocation due to displacement of the articulating bone surfaces. The joint often appears misaligned or abnormal in contour. This finding directly reflects loss of normal joint alignment.

C. Pain and tenderness: Pain and tenderness are common findings in many musculoskeletal injuries, including sprains, fractures, and soft tissue injuries. These symptoms are nonspecific and do not distinguish dislocation from other joint injuries. Additional assessment findings are needed to confirm dislocation.

D. Increased range of motion in a joint: Dislocation typically results in decreased or absent range of motion due to pain, muscle spasm, and mechanical blockage. Increased range of motion is more characteristic of ligamentous laxity or instability. It does not indicate a joint dislocation.