Signalement:
The patient is a 32-year-old African American woman.

Signs:
The patient gave birth two years ago and is experiencing irregular and infrequent periods, her skin is slightly thickening and she is experiencing darkening of the skin around her neck, which is hyperpigmentation (Saedi & Ganesan, 2013).

Symptoms:
The patient is experiencing variation of menstrual flow between periods, she is frequently urinating (polyuria) and has excessive thirst (polydipsia).

Diagnostics:
- 138/88 blood pressure
The patient’s blood pressure is above normal. A normal blood pressure reading is 120/80 or below (Fox, 2015, p.503).

- BMI of 29
The patient’s body mass index is above normal. A normal, healthy body mass index range is 18.5-24.9 kg/. …show more content…
A value of 136 mmol/L or less is considered to be below normal (Kajimoto, Minami, Sato, & Takano, 2016).

- Serum potassium 3.6 mmol/L
The patient’s serum potassium level is at a normal range. A level of 3.5 mmol/L or less is considered to be below average, which can result to hypokalemia (Krijthe et al., 2013).

- Fasting blood glucose 8.8 mmol/L
The patient’s fasting blood glucose levels are above normal. A normal range is considered 6.0 mmol/L. A range over 6.0 to 6.9 is impaired fasting blood glucose, pre-diabetes. A range of 7.0 and over is an indicator of diabetes (Hatzakorzian et al., 2011).

- Hematocrit 44%
The patient’s hematocrit percentage level is above normal. A normal range should be less than 42%. When the level is above 45%, whole-blood viscosity increases above normal (Spivak, 2013).

- White blood cells 4.5 x /L
The patient’s white blood cell count is normal. From the study of Hsu et al., 2010, patients with a white blood cell count greater than 6.2 x /L has elevated blood pressure, body mass index, cholesterol, LDL and triglyceride levels (Hsu, Lin, Lin-Tan, Yen, & Chen, …show more content…
The patient is taking hydrochlorothiazide, which is a diuretic for hypertension. This could cause dehydration to worsen. The patient reports having excessive thirst and frequently urinating. Being dehydrated would raise blood osmolality, which would stimulate the hypothalamus for the sensation of thirst. Type 2 diabetes mellitus has a bond with metabolic syndrome. This syndrome and its symptoms have a close association to obesity and type 2 diabetes. It is aware that the patient is overweight, with a body mass index of 29, and is borderline obese (Palmer et al., 2012). In the study of Davey et al., 2012, it was stated how African-Americans are more likely to have diabetes mellitus than Caucasians. The symptoms of metabolic syndrome include hypertension, high triglyceride concentration, low HDL concentration, and high LDL concentration. In the physical exam, it was made aware that the patient does have hypertension (The patient’s blood pressure is 138/88, which is above normal. A normal blood pressure reading is 120/80 or below)(Fox, 2015, p.503) and has a very low HDL cholesterol concentration, but has normal triglyceride and LDL concentrations. The variation of menstrual flow between the patient’s periods is not a symptom of diabetes. The patient stated she gave birth within the last two year and her physical exam states that her acne is being treated by oral contraceptives. These are symptoms