PLEASE complete accurately 2 case studies. Below I have attached the Template, Rubric/Guidelines, an Example Case Study, AND ALSO A template to Plug in the information/rearrange or take out information as needed for the case study. No plagiarism, provided proof of TurnItIn document. No references order than 5 years. Diagnosis to use 1st Case Study > DIABETES TYPE 2 Differential Diagnosis=  Diabetes Type 1 Mellitus & Cushing Syndrome 2nd Case Study > HYPERTENSION Differential Diagnosis = Congestive Heart failure & Chronic Kidney Disease.

Case Study 1: Diabetes Type 2

Introduction:
Diabetes mellitus type 2 is a chronic metabolic disorder characterized by high blood glucose levels, insulin resistance, and inadequate insulin production (American Diabetes Association, 2018). The condition is primarily caused by a combination of genetic and lifestyle factors, such as obesity and physical inactivity (American Diabetes Association, 2020). This case study aims to provide an in-depth analysis of a patient presenting with diabetes type 2 and differentiate it from other potential diagnoses, specifically diabetes type 1 mellitus and Cushing syndrome.

Patient Information:
The patient is a 45-year-old male with a history of obesity and a sedentary lifestyle. He presents with increased thirst, frequent urination, fatigue, and unexplained weight loss over the past six months. The physical examination reveals central obesity, acanthosis nigricans, and elevated blood pressure.

Differential Diagnosis:
1. Diabetes Type 1 Mellitus: This autoimmune disorder is characterized by the destruction of pancreatic beta cells, resulting in absolute insulin deficiency (American Diabetes Association, 2018). It typically presents in younger individuals and is not associated with obesity or insulin resistance.

2. Cushing Syndrome: This disorder occurs due to chronic exposure to excessive cortisol levels, either endogenously or exogenously (American Association of Clinical Endocrinologists, 2019). Common manifestations include central obesity, hypertension, glucose intolerance, and muscle wasting.

Diagnostic Tests:
To differentiate diabetes type 2 from the alternative diagnoses, the following diagnostic tests are recommended:

1. Fasting Plasma Glucose (FPG) Test: This test measures the patient’s blood glucose levels after an overnight fast. In diabetes type 2, FPG levels are often elevated but not as high as in diabetes type 1 mellitus.

2. Hemoglobin A1c (HbA1c) Test: This test provides a measure of average blood glucose levels over the past three months. It is useful in monitoring long-term glycemic control and can help differentiate between diabetes types 1 and 2. Diabetes type 2 is usually associated with elevated HbA1c levels.

3. C-peptide Test: This test measures the level of C-peptide, a protein produced in conjunction with insulin. Low levels of C-peptide suggest insulin deficiency, which is characteristic of diabetes type 1 mellitus.

4. 24-Hour Urinary Free Cortisol Test: This test measures cortisol levels in a patient’s urine over a 24-hour period. Elevated levels may indicate Cushing syndrome.

Treatment Plan:
If the patient is diagnosed with diabetes type 2, the treatment plan involves lifestyle modifications and pharmacotherapy. The patient should be educated about the importance of maintaining a healthy diet, regular exercise, and weight loss to improve insulin sensitivity. Pharmacologically, oral antidiabetic medications or, in some cases, insulin therapy may be initiated to regulate blood glucose levels.

Case Study 2: Hypertension

Introduction:
Hypertension, commonly referred to as high blood pressure, is a prevalent cardiovascular disorder characterized by persistently elevated blood pressure levels (World Health Organization, 2013). It is a major risk factor for various cardiovascular diseases, including congestive heart failure and chronic kidney disease. This case study aims to analyze a patient presenting with hypertension and differentiate it from these potential diagnoses.

Patient Information:
The patient is a 55-year-old female with a sedentary lifestyle. She has a past medical history of obesity, smoking, and a family history of hypertension. She presents with complaints of frequent headaches, dizziness, and occasional shortness of breath. Physical examination reveals elevated blood pressure readings and signs of left ventricular hypertrophy.

Differential Diagnosis:
1. Congestive Heart Failure (CHF): CHF is a clinical syndrome characterized by the inability of the heart to pump sufficient blood to meet the body’s demands (American Heart Association, 2020). It often presents with symptoms such as shortness of breath, fatigue, and fluid retention.

2. Chronic Kidney Disease (CKD): CKD refers to the progressive loss of kidney function over time (National Kidney Foundation, 2019). It is associated with various cardiovascular complications, including hypertension. Symptoms may include fatigue, fluid retention, and increased frequency of urination.

Diagnostic Tests:
To differentiate hypertension from the alternative diagnoses, the following diagnostic tests are recommended:

1. Electrocardiogram (ECG): This test records the electrical activity of the heart. It may reveal signs of left ventricular hypertrophy, which is more indicative of hypertension.

2. Echocardiography: This imaging test uses ultrasound waves to assess the structure and function of the heart. It can help identify any abnormalities, such as impaired cardiac function or valve defects, which may be present in congestive heart failure.

3. Measurement of Renal Function: Blood tests, such as serum creatinine and estimated glomerular filtration rate (eGFR), can evaluate kidney function. A decreased eGFR may indicate chronic kidney disease.

Treatment Plan:
If the patient is diagnosed with hypertension, the treatment plan involves lifestyle modifications and pharmacotherapy. Lifestyle modifications include dietary changes, regular exercise, smoking cessation, and stress management. Depending on the patient’s blood pressure levels and comorbidities, antihypertensive medications may be prescribed to control blood pressure and reduce the risk of cardiovascular complications.