Case study for advanced Pharmacology. Health, Medicine Case Study

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Date: June 23, 2020
Chief Complaint: “I have been having fatigue and cough for the past three months. This has been on-and-off for the past two years.”
Health History
Mrs A is a 56-year-old Hispanic woman who lives in the suburbs of Texas, USA. She has been working as a department store cashier for the last twenty years. Mrs A came to the clinic feeling feverish. She had a productive cough accompanied by yellowish, mucoid sputum. Moreover, she feels a sharp pain on her right chest (as pointed by the patient) during inspiration.
Mrs. A states that she started feeling fatigued three months ago after working for straight seven hours. It started as a dry cough which gradually became a productive cough. The colour of the sputum at the time started as whitish mucoid then turned to yellowish-green mucoid sputum. Soon after, Mrs. A incurred an on-and-off fever measuring 37-42 degrees Celsius. Eight days ago, Mrs. A experienced sudden shortness of breath upon walking for a short distance (approximately 10 meters) where she can usually jog for this length at moderate speed without having to catch her breath. The shortness of breath and fatigue was exacerbated by easy activities such as walking around the house and washing the disease, and these are relieved by resting for approximately thirty minutes. Mrs. A remembered of having cold-like symptoms for three days before the occurrence of the fatigue and productive cough. After this, the cough progressed rapidly until the clinic check-up. The night before the consultation, Mrs. A had a high fever measuring 39 degrees Celsius which was partially relieved by taking Paracetamol 500mg thrice at 4-hour intervals. This is also accompanied by chest pain and tightness where she feels a sharp pain on her right chest, especially during inspiration.
Currently, the patient has been taking Losartan 50 mg orally, once daily, as a maintenance medication for five years. She is also taking Vitamin C religiously every day since last year to boost her immune system.
Mrs. A denies any known allergies on food and medications. She was diagnosed with essential hypertension in 2010 and had been taking her medications religiously. She denied any history of hospitalization for the past five years and no history of surgeries in her lifetime. She has not encountered any accidents or incurred injuries. Her latest travel was in December 2018.
Family history reveals that both her parents and two out of three of her siblings had hypertension before the age of 55. Her father died of lung cancer in 2001 while her mother died of cardiac arrest in 2004—all of her children and strong and healthy without any known familial diseases or disorders.
Mrs. A denies any smoking history. However, her husband admitted that she was a smoker for 20 years, and she takes approximately 2-3 sticks of cigarette per day. She stopped smoking three months ago when she noticed that her productive cough does not stop when she continues smoking. She was an alcoholic beverage drinker who only drinks beer and tequila from she was 15 to 30 years old. She stopped drinking after that. However, she sips a glass of red wine once a ...