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CONTINUING PROFESSIONAL DEVELOPMENT
attempt another trial of esomeprazole
20 mg daily currently, she was happy to
consider it in the future and for this to be
noted in the report to her GP.
Approximately one month after Mrs
M’s HMR, she visited the pharmacy
and explained that the perindopril/
indapamide 4 mg/1.25mg dose had been
reduced to one tablet daily. She was very
happy to be taking one less tablet a day.
Mrs M had continued to measure her
blood glucose levels twice daily as
she found that her measurements had
been inconsistent and recorded these
in a Diabetes Record Book. Mrs M’s GP
measured HbA1c and indicated that
he would like to see Mrs M again in
two weeks and asked her to bring her
self-recorded blood glucose levels.
The GP agreed that once Mrs M’s blood
glucose levels had stabilised, it was likely
that there would no longer be a need to
self-monitor blood glucose.
There were no longer any adherence
issues with tiotropium in this patient.
It took approximately six weeks for Mrs M
to recover from the exacerbation of COPD
which was the cause of her cough and
chest congestion and she explained that
this was motivation to ensure that she
took her tiotropium regularly.
Eight weeks after Mrs M’s HMR, she
had lost a further 3 kg. She expressed
some disappointment that it wasn’t
more, but when asked if she had been
restricted in her lifestyle by her recent
COPD exacerbation, she said that she
had difficulty with being short of breath
when walking and had her family drive
her to undertake her weekly tasks
instead of walking as she usually did.
It is important to encourage weight
loss in patients who are overweight or
obese. An explanation of the benefits
of weight loss for disease states is likely
to be useful in encouraging patients
to lose weight. It is also important that
a multidisciplinary approach ensures
that other health care professionals are
aware of the information that has been
given to patients so that follow-up can
occur, which is more likely to result in
sustained weight loss in the patient.
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glycosylated hemoglobin and intentional weight loss
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1. Obesity increases the risk of the
following diseases EXCEPT?
b) Musculoskeletal disease.
c) Diabetes mellitus.
d) None of the above, i.e . obesity increases
the risk of all of the above.
2. Possible mechanisms by which
obesity may cause hypertension are
the following EXCEPT?
a) Increased activity of the sympathetic
b) Inhibition of natriuretic peptide system.
c) Signalling of mechanoreceptors on the
surface of chondrocytes.
d) Overactivation of the renin-angiotensin-
3. Which of the following statements
is FALSE in regards to excess weight
and airways disease?
a) Increased BMI leads to an increase in FEV1
b) Increased BMI causes a decrease in
forced vital capacity.
c) Central obesity inhibits diaphragm
movement during inspiration.
d) Obesity can cause airways resistance.
4. Which of the following statements is
a) Sixty percent of Australians are overweight
b) Life expectancy is reduced by two to
four years in individuals with a BMI of
c) The increase in osteoarthritis in
individuals with excess weight
compared to those of healthy weight
only affects weight bearing joints.
d) Weight loss in individuals with type 2
diabetes mellitus that are overweight
results in a reduction in blood glucose
levels but not in HbA1c.
5. Which of the following statements is
a) A reduction in body weight by 1%
reduces systolic blood pressure by an
average of 1 mmHg.
b) The effects of weight loss on blood
pressure reductions in individuals who
are overweight or obese are reduced
in patients taking antihypertensive
c) Weight loss is of no benefit in insulin
d) Discussions of weight should be
avoided during HMRs.
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