12-16-2009, 04:46 PM
first i am sorry for being unorganized but i couldnt do better in writing them
1) a man with a chronic back pain came to ER today with increasing pain which spreads to the lower part of his abdomen, the patient has a history of DM, HTN, smoking, with physical exam there is a severe back pain dosent spread to lower extremities, small bruit in the abdomen, weak pulses in the feet, i dont want to put what he did or what i think but he ordered xray which showed curvilinear around one vertebral body ,after ordering some things he ordered abdomen ct and showed abdominal aortic aneurysm rupture
(and then ofcourse stat surgery)
2) an overweight man ( who doesnt see a doctor and dosent take any medication) came to the office with his wife, he said that he did his labs somewhere and was told that something is wrong in the labs he is not sure but maybe his lipids, with exam and labs in the office he has mild htn, mild hyperlipidemia, and some SOB, he is a smoker .
it showed then that he has COPD ( what a complicated case)
smoking cessation, exercise program, and low salt, low cholesterol, low calori diet and send home, albuterol and send home. he stopped smoking
with the next visits he developed and felt much better and his labs and bp were good and he is so thankful but the problem is his wife is still worried ( what the hell is ----)
in the last visit he gave him vaccinations and added ipratropium
again sorry for not being organized
good luck
1) a man with a chronic back pain came to ER today with increasing pain which spreads to the lower part of his abdomen, the patient has a history of DM, HTN, smoking, with physical exam there is a severe back pain dosent spread to lower extremities, small bruit in the abdomen, weak pulses in the feet, i dont want to put what he did or what i think but he ordered xray which showed curvilinear around one vertebral body ,after ordering some things he ordered abdomen ct and showed abdominal aortic aneurysm rupture
(and then ofcourse stat surgery)
2) an overweight man ( who doesnt see a doctor and dosent take any medication) came to the office with his wife, he said that he did his labs somewhere and was told that something is wrong in the labs he is not sure but maybe his lipids, with exam and labs in the office he has mild htn, mild hyperlipidemia, and some SOB, he is a smoker .
it showed then that he has COPD ( what a complicated case)
smoking cessation, exercise program, and low salt, low cholesterol, low calori diet and send home, albuterol and send home. he stopped smoking
with the next visits he developed and felt much better and his labs and bp were good and he is so thankful but the problem is his wife is still worried ( what the hell is ----)
in the last visit he gave him vaccinations and added ipratropium
again sorry for not being organized
good luck