Issues List for Multi-Issue Consults

1. Hypertension - Patient presents with elevated blood pressure readings over the past month, experiencing occasional headaches and dizziness. - Past medical history includes a diagnosis of hypertension 2 years ago, currently on Lisinopril 10mg daily. - Blood pressure recorded at 150/95 mmHg, heart rate 78 bpm. No signs of end-organ damage. - Likely diagnosis: Uncontrolled Hypertension - Investigations planned: 24-hour ambulatory blood pressure monitoring - Treatment planned: Increase Lisinopril to 20mg daily, lifestyle modifications including low-sodium diet and regular exercise 2. Type 2 Diabetes Mellitus - Patient reports increased thirst and frequent urination over the past few weeks. - Past medical history includes Type 2 Diabetes diagnosed 5 years ago, on Metformin 500mg twice daily. - Blood glucose level at 11.5 mmol/L, HbA1c at 8.2%. - Likely diagnosis: Poorly Controlled Type 2 Diabetes Mellitus - Treatment planned: Add Glimepiride 2mg daily, dietary consultation for diabetes management - Relevant referrals: Referral to endocrinologist for further management 3. Lower Back Pain - Patient complains of persistent lower back pain for the past 3 months, worsened by prolonged sitting. - No significant past medical history related to back pain. - Physical examination reveals tenderness in the lumbar region, reduced range of motion. - Likely diagnosis: Mechanical Lower Back Pain - Differential diagnosis: Lumbar disc herniation - Investigations planned: MRI of the lumbar spine - Treatment planned: Physiotherapy referral, NSAIDs for pain management