Patient with Blurred Vision and Bilateral Leg Pain

  >   Rahul's Noteblog   >   Notes on USMLE facts, Exam Tips, and USMLE Lab Values   >   Patient with Blurred Vision and Bilateral Leg Pain

NOTE: incomplete file

Chief complaint:

A 56 y.o. African American male presents to the ER with blurred vision, bilateral leg pain and respiratory distress.

Patient History:

Diabetes Mellitus.

Differential dx:

Acute asthma bronchitis.

COPD.

CHF.

Final dx:

Acute asthma bronchitis.

COPD.

CHF.

Cardiomegaly.

Tests:

Venous Doppler is normal.

D-Dimer (fibrin degradation product used to diagnose DVT); (results are due).

Comprehensive metabolic panel (repeat daily).

Patient refused V/Q scan (can't lie flat).

X-ray reveals cardiomegaly.

Physical Examination:

Peripheral edema.

Blurry vision present.

Current Medications:

Lasix/Furosemide/loop diuretic (Ordered by ER physician).

Ecotrin/Aspirin/acetylsalicylic acid (Ordered by ER physician).

Morphine (Ordered by ER physician).

Atrovent/Ipratropium (anticholinergic drug that blocks muscarinic cholinergic receptors) (Ordered by ER physician).

Insulin (Ordered by ER physician).

Captopril (ACE inhibitor) (Ordered by FP physician).

Digoxin/cardiac glycoside (cardiac action potential and decreased K+ conductance) (Ordered by FP physician).

Dopamine/vasopressor agent (to increase cardiac output and organ perfusion) (Ordered by FP physician).

Lasix (Ordered by FP physician).

Actos/pioglitazone (to improve glycemic control) (Ordered by FP physician).

Glucotrol/glipizide (sulfonylurea used to improve glycemic control) (Ordered by FP physician).

Protomix (proton pump inhibitors used to reduce gastric acid production) (Ordered by FP physician).

Spironolactone (K-saving diuretic) (Ordered by FP physician).

Vasotec/Enalapril (ACE inhibitor) (Ordered by FP physician).

Heparin (Ordered by FP physician).

Avelox/Moxifloxacin (a fluoroquinolone that blocks DNA unwinding and replication) (Ordered by FP physician).

Albuterol (short-acting alpha agonist used for acute asthma) (Ordered by FP physician).

Bactroban (mupirocin; used to treat skin infections) ointment to nares (Ordered by FP physician).

Miscellaneous Notes:

Cardiomegaly due to opioid abuse.

Pericardial Effusion.

Can't lie still.

CMP results improving.

Additional Reading:

Interesting Case Histories

1. Patient with Blurred Vision and Bilateral Leg Pain
2. Patient with Abdominal Pain and Gas

Random Pages:

The Big Bang: Proof that the Universe is Expanding Review of Delta Roma Imperiale Fountain Pen
Video of me playing Hagood Hardy`s "The Homecoming" Notes on Renal/Urinary System
Notes on Arteries of the Axilla Notes on Growth Medias and Oxygen Requirements
Notes on Purine and Pyrimidine Metabolism Notes on Correlational Techniques
FAQ on Male Reproduction Notes on Digestion
Notes on Basic Gastrointestinal Physiology Why did I become a doctor?
Pictures of old Kuwaiti Dinars What is an ELEK`s Test?
Why did I decide to become a doctor? Medical School Admissions Essay Video: Titanic Piano Theme: The Portrait
Corporate Failure: The Enron Case My Experience during the Iraqi Invasion of Kuwait
USMLE Blood Lab Values Regulation of Heart Rate by Autonomic Nervous System
Images of Antibodies Video of me playing Hagood Hardy`s "The Homecoming"
Notes on Respiratory System Differentiation and Anatomy of a Blastocyst
Notes on Cell Components Notes on Nervous Tissue
Voices from Hell: My Experience in Mussoorie, India Video of Cardiology Examination in a Clinical Setting

Please Do Not Reproduce This Page

This page is written by Rahul Gladwin. Please do not duplicate the contents of this page in whole or part, in any form, without prior written permission.