A 40-year-old man with a history of uncontrolled diabetes pr…
A 40-year-old man with a history of uncontrolled diabetes presents to the clinic for his yearly follow-up. His recent laboratory tests show sodium 132 mEq/L (normal 136–145 mEq/L), creatinine 1.4 mg/dL, GFR 55 mL/min/1.73 m2, and glucose 450 mg/dL. His urinalysis is positive for glucose. He is asymptomatic. Which of the following is high priority and next step in his management?
Read Details93. A 70-year-old male with past medical history of mild-mod…
93. A 70-year-old male with past medical history of mild-moderate mitral regurgitation and moderate-severe tricuspid regurgitation, COPD, and secondary pulmonary hypertension presents to the Emergency Department with a fever and new cough. Vitals on presentation are notable for a blood pressure of 80/43, temperature of 38.7°C, and oxygen saturation of 80% on room air, which improves modestly with 6 L oxygen by nasal cannula. Chest radiograph shows multifocal airspace opacities suggestive of pneumonia, but not pulmonary edema. He is transferred to the ICU for intubation. Examination is also notable for cool extremities with +1 symmetric lower extremity edema. In determining whether to administer fluids to this patient to augment his mean arterial pressure, which of the following techniques would be LEAST helpful?
Read Details23. A 27-year-old man presents to the emergency department c…
23. A 27-year-old man presents to the emergency department complaining of muscle pain, weakness, and reddish-brown urine. He states that while moving furniture yesterday he got pinned under a dresser. He has large areas of bruising over his bilateral thighs. Which additional finding would confirm the suspected diagnosis?
Read Details66. Ms. T.G. is an 80 y/o female initially admitted to the I…
66. Ms. T.G. is an 80 y/o female initially admitted to the ICU for septic shock due to UTI. She developed acute respiratory failure and was intubated for airway protection. After 2 weeks on the ventilator she became febrile, tachycardic and tachypneic; Lactate was 3.1. You would prescribe
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