Biochemistry

1) a. What condition does Krishna present with and explain your reason for this diagnosis?You have described risk factors related to blood lipids but glucose, blood pressure and anthropometry should have also been considered, and this cluster of risk factors should have led you to Metabolic Syndrome(2/10)2) b. Identify the risk factors from the nutritional assessment and explain the pathophysiological mechanisms that increase Krishna’s risk of disease.You have identified some of the factors related to diet and exercise but many important risk factors have not been described and you have not explained the relevant pathophysiology. Some discussion of visceral adiposity and the metabolic consequences of this that increase risk of CHD and T2D should have been described here.(7/25)c. Provide a diet and lifestyle intervention plan for Krishna and clearly explain the aims of the intervention.You have provided some general recommendations, but more case study specific recommendations are needed. An improved example diet plan could have been provided as a table in the main document or as an appendix to not impact on your word count. You do mention alcohol in other sections.(10/30)3)c. Provide a diet and lifestyle intervention plan for Krishna and clearly explain the aims of the intervention.You have provided some general recommendations, but more case study specific recommendations are needed. An improved example diet plan could have been provided as a table in the main document or as an appendix to not impact on your word count. You do mention alcohol in other sections.(10/30)d. What barriers do you think Krishna may have to making dietary changes?Some points for consideration are established eating habits are difficult to change. Is knowledge about a healthy diet a barrier (you do mention education in the next section)? Is a family centred approach needed as Krishna’s wife prepares evening meals?(5/10)e. How would you ensure Krishna is engaged with the intervention and what outcome measures would you suggest for monitoring Krishna’s goals?Some guidance on goal setting, more on outcome measures such as waist circumference that Krishna can monitor himself also biochemical measures could be taken by periodically by professional.(7/15)f. Krishna asks about dietary supplements such as fish oil, garlic oil and vitamin D and whether these would be beneficial considering his family history. How would you advise him?You have made some recommendations, but relevant detail and a current evidence base is lacking.(1/5)g. Explain why Krishna should be referred to his doctor for further tests.Krishna is showing signs of altered glucose metabolism so needs further tests to identify if this is the early signs of insulin resistance as the identified risk factors and the family history of hypertension and CHD puts Krishna at a high risk for Type II Diabetes and CHD.Krishna is showing signs of abnormal blood lipids, treatment to reduce cholesterol levels and lower blood pressure may be needed. The GP referral may necessitate further referral to a Dietician.(2/5)Consider everything and make a better result.