Post by akirnitov on Dec 5, 2005 0:13:02 GMT 7
CASE:1
a 56 year old women came to the hospital with swelling and pain on her left leg
history of present illness:
the swelling started 2 days ago following a very long drive. swelling was first seen behind left knee and with gradual spreading to the left leg
history:
-hypertensive ...long history of low back pain due to fall on wet floor years ago
-Whenever required to sit for long periods, patient remains relatively immobile to minimize any chance of acute exacerbation of chronic back pain
-Physical Examination
Vital Signs: Oral temperature, 98.2°F/36.8°C; respiratory rate, 16/min; pulse rate, 86/min; blood pressure, 143/92 mm Hg; O2 saturation, 98% on room air
General: Alert, responsive, moderately obese woman with nontoxemic appearance
Lungs: Normal symmetric excursion of chest. Nonlabored breathing. No rales, rhonchi, or wheeze noted. No tenderness to palpation.
Cardiac: Normal S1 and S2. No rubs or gallops noted. Grade 2/6 systolic ejection murmur at left upper sternal border.
Vascular: Dorsalis pedis and posterior tibial pulses 2+ bilaterally. Upper and lower extremities pink and well perfused.
Extremities: Left leg: 2+ nonpitting edema from ankle to upper thigh; mild tenderness to palpation along entire length of swelling; no erythema or lymphangitic streaking; intact skin with normal temperature and no ecchymosis, abrasions, or other evidence of trauma; no masses appreciated. Right leg: Unremarkable.
question one...what differential diagnosis do u suggest and why??
question two....what laboratory test do u suggest for ur final diagnosis?
question three....what do u think is causing the problem..ur diagnosis of disease?
question four...try to suggest medication and why
a 56 year old women came to the hospital with swelling and pain on her left leg
history of present illness:
the swelling started 2 days ago following a very long drive. swelling was first seen behind left knee and with gradual spreading to the left leg
history:
-hypertensive ...long history of low back pain due to fall on wet floor years ago
-Whenever required to sit for long periods, patient remains relatively immobile to minimize any chance of acute exacerbation of chronic back pain
-Physical Examination
Vital Signs: Oral temperature, 98.2°F/36.8°C; respiratory rate, 16/min; pulse rate, 86/min; blood pressure, 143/92 mm Hg; O2 saturation, 98% on room air
General: Alert, responsive, moderately obese woman with nontoxemic appearance
Lungs: Normal symmetric excursion of chest. Nonlabored breathing. No rales, rhonchi, or wheeze noted. No tenderness to palpation.
Cardiac: Normal S1 and S2. No rubs or gallops noted. Grade 2/6 systolic ejection murmur at left upper sternal border.
Vascular: Dorsalis pedis and posterior tibial pulses 2+ bilaterally. Upper and lower extremities pink and well perfused.
Extremities: Left leg: 2+ nonpitting edema from ankle to upper thigh; mild tenderness to palpation along entire length of swelling; no erythema or lymphangitic streaking; intact skin with normal temperature and no ecchymosis, abrasions, or other evidence of trauma; no masses appreciated. Right leg: Unremarkable.
question one...what differential diagnosis do u suggest and why??
question two....what laboratory test do u suggest for ur final diagnosis?
question three....what do u think is causing the problem..ur diagnosis of disease?
question four...try to suggest medication and why