Patient Scenario:

You are a junior doctor assigned to a Department of Medical Prevention (DMP) in a large urban clinic. Today, you meet Mr. Ivan Petrov, a 52-year-old factory worker.

During the initial questionnaire in the Anamnestic Office, you learn:

• He has smoked for 25 years (1 pack/day).
• His diet is high in processed foods, and he rarely exercises.
• He has mild overweight (BMI 28 kg/m²).
• He reports occasional shortness of breath on exertion, but no other symptoms.
• He has not had a medical check-up in 5 years.

Measurements and rapid tests in the Health Center reveal:

• Blood pressure: 145/90 mmHg
• Total cholesterol: 6.5 mmol/L
• Blood glucose (rapid test): 6.2 mmol/L
• Spirometry shows slightly reduced lung function
• CO in exhaled air: 18 ppm

The Health Center physician asks you to design a plan for preventive care, counseling, and follow-up.

Questions:

• Identify Mr. Petrov’s main risk factors for chronic non-communicable diseases (NCDs).
• What are the priority areas for intervention in his case?

• Which primary, secondary, and tertiary prevention measures would you apply for Mr. Petrov?
• How could Health Schools and group training help him?
• Which equipment or tools in the Health Center would be most useful in monitoring his progress?

• What communication strategies would you use to motivate Mr. Petrov to adopt a healthier lifestyle?
• How would you assess his understanding and readiness for change?

• How does Mr. Petrov’s case illustrate the importance of preventive care at the population level?
• What system-level measures could improve participation of patients like him in preventive programs?