A 45 year old man is being seen because he has been experiencing vision changes, a burning sensation in his feet, and decreasing amounts of urine when he uses the bathroom

A  45 year old man is being seen because he has been experiencing vision changes, a burning sensation in his feet, and decreasing amounts of urine when he uses the bathroom. He has a long-standing history of hypertension and hyperlipidemia. Your physical exam reveals retinal hemorrhages in both eyes, and decreased sensation to moderate touch in the soles of his feet. A spot urinalysis shows microalbuminuria and a stat Basic Metabolic Profile (BMP) shows decreased Glomerular Filtration Rate (GFR).

a. Present your initial diagnosis.

b. Describe the pathophysiologic processes related to your diagnosis that explain the signs/symptoms, and lab results obtained.

c. State the effect of his symptoms on his life expectancy and the rationale for your answer.

Estimated time to complete: 6 hours

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