View more documents from Hector Marrufo.
martes, 29 de marzo de 2011
jueves, 24 de marzo de 2011
miércoles, 16 de marzo de 2011
APREDIZAJE BASADO EN PROBLEMAS (CASO CLINICO)
A 51-year-old female has had fatigue, weakness, and shortness of breath (SOB) with exertion during the past 4-5 days. She called her primary care physician (PCP) who recommended that she had her hemoglobin checked. He called her back with the results, and told her to go to the emergency room (ER) for further treatment of severe anemia. On admission, the patient denied abdominal pain, chest pain, congestion, nausea/vomiting/diarrhea/constipation (N/V/D/C), dysuria, headache, chills, hemoptysis, neck pain, rash, or sore throat.
Her symptoms were exacerbated by activity and relieved by rest and laying supine. She also felt palpitations intermittently.
Past Medical History (PMH)
Diabetes type 2 (DM2).
Medications
Lantus (Insulin glargine, rDNA origin) 25 mg SQ QHS, Humalog (insulin lispro) SSI SQ with Accu-Chek Blood Glucose Monitoring TID.
Physical Examination
VS: mild tachycardia, no hypotension.
General appearance: pale, non-icteric.
Eyes: EOMI, PERRLA, sclerae non-icteric.
ENT: Oropharynx clear, no plaques or exudates.
Chest: CTA (B).
CVS: Clear S1S2.
Abd: Soft, NT, ND, +BS.
Ext.: no cyanosis/clubbing/edema (c/c/e).
Neurologic: AAA x 3.
No lymphadenopathy.
What is the most likely diagnosis?
What are the most likely causes of this ?
What laboratory workup would you order?
How would you treat this patient?
Her symptoms were exacerbated by activity and relieved by rest and laying supine. She also felt palpitations intermittently.
Past Medical History (PMH)
Diabetes type 2 (DM2).
Medications
Lantus (Insulin glargine, rDNA origin) 25 mg SQ QHS, Humalog (insulin lispro) SSI SQ with Accu-Chek Blood Glucose Monitoring TID.
Physical Examination
VS: mild tachycardia, no hypotension.
General appearance: pale, non-icteric.
Eyes: EOMI, PERRLA, sclerae non-icteric.
ENT: Oropharynx clear, no plaques or exudates.
Chest: CTA (B).
CVS: Clear S1S2.
Abd: Soft, NT, ND, +BS.
Ext.: no cyanosis/clubbing/edema (c/c/e).
Neurologic: AAA x 3.
No lymphadenopathy.
What is the most likely diagnosis?
What are the most likely causes of this ?
What laboratory workup would you order?
How would you treat this patient?
jueves, 3 de marzo de 2011
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