Mr. J.R. is a 52-year-old Hispanic male presenting for a routine follow-up. He reports fatigue, increased thirst, and weight gain over the past year.
History:
· PMH: Type 2 diabetes (6 years), hypertension, dyslipidemia, obesity
· Medications: Metformin 1000 mg BID, Lisinopril 10 mg daily, Atorvastatin 20 mg nightly
· Social: Sedentary lifestyle, works two jobs, limited access to healthy food
· Family history: Father with MI at 59
Vitals:
· BP: 148/92 mmHg
· BMI: 36 kg/m²
Labs:
· A1C: 9.1%
· LDL: 142 mg/dL
· Triglycerides: 265 mg/dL
· eGFR: 68 mL/min/1.73m²
· Urine albumin/creatinine ratio: 45 mg/g
Student Assignment Requirements (APA 7)
Students must submit a 7–9 page scholarly paper (excluding title and references) addressing:
1. Pathophysiology (25%)
· Explain the interrelationship between insulin resistance, obesity, hypertension, dyslipidemia, and endothelial dysfunction
· Describe progression to microvascular and macrovascular complications
· Integrate evidence-based literature
2. Comprehensive Assessment (30%)
· Focused and comprehensive primary care assessment
· Cardiovascular risk stratification (ASCVD)
· Identification of red flags and complications
· Preventive care and screening needs
3. Pharmacology & Management (35%)
· Evidence-based medication optimization per ADA, ACC/AHA, and KDIGO guidelines
· Justification for adding/changing medications (e.g., GLP-1 RA, SGLT2 inhibitor)
· Non-pharmacologic management
· Monitoring and follow-up plan
4. Scholarly Writing & APA Format (10%)
· Use of current (≤5 years) peer-reviewed sources
· APA 7 accuracy and clarity
RUBRIC – CASE STUDY 1 – Cardiometabolic Syndrome in Adult Primary Care (100 Points)
1. Pathophysiology (25 points)
Level
Description
Excellent (23–25)
Demonstrates an advanced, accurate explanation of cardiometabolic pathophysiology, clearly integrating insulin resistance, obesity, dyslipidemia, hypertension, and vascular inflammation. Shows strong synthesis of current evidence and applies mechanisms directly to the patient case.
Satisfactory (18–22)
Explains core pathophysiologic concepts correctly with minor gaps in depth or integration. Connections to the patient scenario are present but may lack full synthesis.
Unsatisfactory (13–17)
Provides a basic or partially inaccurate discussion of pathophysiology. Limited linkage between mechanisms and clinical manifestations.
Poor (1–12)
Pathophysiology is superficial, inaccurate, or largely descriptive with minimal understanding of disease mechanisms.
Not Submitted (0)
Section not submitted or missing.
2. Comprehensive Assessment & Clinical Reasoning (30 points)
Level
Description
Excellent (28–30)
Presents a comprehensive, prioritized assessment including risk stratification, complication screening, and preventive care. Demonstrates excellent clinical judgment and aligns findings with guidelines.
Satisfactory (22–27)
Assessment is appropriate and accurate but lacks depth, prioritization, or full integration of preventive and risk-based care.
Unsatisfactory (16–21)
Incomplete assessment with missing key elements or limited clinical reasoning.
Poor (1–15)
Assessment is disorganized, incomplete, or clinically unsafe.
Not Submitted (0)
Section not submitted or missing.
3. Pharmacology & Evidence-Based Management (35 points)
Level
Description
Excellent (33–35)
Develops a comprehensive, guideline-based pharmacologic and non-pharmacologic plan. Medication choices are fully justified, safe, and patient-centered with appropriate monitoring and follow-up.
Satisfactory (26–32)
Management plan is generally appropriate but may lack full justification, optimization, or monitoring details.
Unsatisfactory (18–25)
Pharmacologic plan demonstrates limited understanding of guidelines or contains omissions or questionable choices.
Poor (1–17)
Plan is unsafe, unsupported by evidence, or demonstrates poor pharmacologic reasoning.
Not Submitted (0)
Section not submitted or missing.
4. Scholarly Writing & APA Format (10 points)
Level
Description
Excellent (9–10)
Writing is clear, professional, and well-organized. Correct APA 7 formatting with current, high-quality scholarly sources.
Satisfactory (7–8)
Minor APA or writing errors that do not impede comprehension.
Unsatisfactory (5–6)
Multiple APA or writing errors that detract from clarity.
Poor (1–4)
Significant APA violations and poor academic writing.
Not Submitted (0)
Section not submitted or missing.
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