11-03-2007, 08:47 PM
could you please solve ELDERLY ABUSE CCS
Thanx in advance
Thanx in advance
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Hotobhaga - srayani
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11-04-2007, 04:58 AM
lets start by saying what would the presentation be:
74 year old man comes with his daughter in law due to a R humerus fracture. due to a fall in the park. On PE there are multiple bruises on the back some on the left buttock. PH: COPD, dementia, dribbling mict. PE Complete: Bilateral scaterred rhonchi; healed L colles Depression index Investigations Blood: CBC, BMP, LFT. TSH, Sr B12, sr Folic Acid, lipid profile Urine : R/M stool : FOBT Sputum gram, C/S, AFB PPD Xray Humerus, Xray chest ECG admit to ward;Orders IV access NS NPO except meds NSAIDS LMWH pneumatic compression stockings albuterol inhalor Pulse ox/oxygen Cardiac monitor orthopedic consult move clock by 1 hour to get results of inv 1. CBC: 11000 2. Xray: r lobar infiltrate 3. sputum shows diplococi start Inj ceftrioxone+ erythromycin pt taken up for reduction/splinting of fracture Day2: Interval history cough better CBC again today pain less DC Oxugen DC IV access Change antibiotics as per C/S move pt to home schedule appointment next day consult family therapy: reason for consult: elder abuse counsel medications compliance no smoking no alocohol seat belt pneumovacc now, fluvaccine now, HIB vaccine now Colonoscopy after 7 days CT scan Brain after 7 days |
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