Administrator rev ronin Posted May 5, 2013 Author Administrator Share Posted May 5, 2013 Yes, exclusively breastfeeding. Patient recently menstruated, is on progestin-only oral contraception, not pregnant. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 5, 2013 Author Administrator Share Posted May 5, 2013 Yes, exclusively breastfeeding. Patient recently menstruated, is on progestin-only oral contraception, not pregnant. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 5, 2013 Author Administrator Share Posted May 5, 2013 Yes, exclusively breastfeeding. Patient recently menstruated, is on progestin-only oral contraception, not pregnant. Link to comment Share on other sites More sharing options...
GatorRRT Posted May 5, 2013 Share Posted May 5, 2013 Travel history? Link to comment Share on other sites More sharing options...
GatorRRT Posted May 5, 2013 Share Posted May 5, 2013 Travel history? Link to comment Share on other sites More sharing options...
GatorRRT Posted May 5, 2013 Share Posted May 5, 2013 Travel history? Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 5, 2013 Author Administrator Share Posted May 5, 2013 No recent travel history. OK, time for DDx and labs. Everyone gets to pick one lab (or panel) that they think will most conclusively rule in or out one disease, disorder, or condition. Pick your lab and state what you expect to find. I won't be back for several hours, so take your time... Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 5, 2013 Author Administrator Share Posted May 5, 2013 No recent travel history. OK, time for DDx and labs. Everyone gets to pick one lab (or panel) that they think will most conclusively rule in or out one disease, disorder, or condition. Pick your lab and state what you expect to find. I won't be back for several hours, so take your time... Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 5, 2013 Author Administrator Share Posted May 5, 2013 No recent travel history. OK, time for DDx and labs. Everyone gets to pick one lab (or panel) that they think will most conclusively rule in or out one disease, disorder, or condition. Pick your lab and state what you expect to find. I won't be back for several hours, so take your time... Link to comment Share on other sites More sharing options...
PYRITE Posted May 5, 2013 Share Posted May 5, 2013 CMP, primary finding expected: increased BUN:creatinine ratio (thinking kidney problem secondary to heart issue) Link to comment Share on other sites More sharing options...
PYRITE Posted May 5, 2013 Share Posted May 5, 2013 CMP, primary finding expected: increased BUN:creatinine ratio (thinking kidney problem secondary to heart issue) Link to comment Share on other sites More sharing options...
PYRITE Posted May 5, 2013 Share Posted May 5, 2013 CMP, primary finding expected: increased BUN:creatinine ratio (thinking kidney problem secondary to heart issue) Link to comment Share on other sites More sharing options...
tjohn Posted May 5, 2013 Share Posted May 5, 2013 CMP, expect to find increased BUN and creatinine. R/O Nephrotoxicity secondary to kelfex. Also expect to find electrolyte disturbances, and it's important to calculate the GFR. Link to comment Share on other sites More sharing options...
tjohn Posted May 5, 2013 Share Posted May 5, 2013 CMP, expect to find increased BUN and creatinine. R/O Nephrotoxicity secondary to kelfex. Also expect to find electrolyte disturbances, and it's important to calculate the GFR. Link to comment Share on other sites More sharing options...
tjohn Posted May 5, 2013 Share Posted May 5, 2013 CMP, expect to find increased BUN and creatinine. R/O Nephrotoxicity secondary to kelfex. Also expect to find electrolyte disturbances, and it's important to calculate the GFR. Link to comment Share on other sites More sharing options...
GatorRRT Posted May 5, 2013 Share Posted May 5, 2013 CBC- microcitic hypochromic RBCs Serum Feratin- Low Thinking iron deficiency secondary to unsupplemented vegitarian diet, recent menatruation and lactation. Would account for the fatigue, but not the edema . . . Link to comment Share on other sites More sharing options...
GatorRRT Posted May 5, 2013 Share Posted May 5, 2013 CBC- microcitic hypochromic RBCs Serum Feratin- Low Thinking iron deficiency secondary to unsupplemented vegitarian diet, recent menatruation and lactation. Would account for the fatigue, but not the edema . . . Link to comment Share on other sites More sharing options...
GatorRRT Posted May 5, 2013 Share Posted May 5, 2013 CBC- microcitic hypochromic RBCs Serum Feratin- Low Thinking iron deficiency secondary to unsupplemented vegitarian diet, recent menatruation and lactation. Would account for the fatigue, but not the edema . . . Link to comment Share on other sites More sharing options...
Corpsman2PA Posted May 5, 2013 Share Posted May 5, 2013 Additional question...sexually active? Last mammo? I'd really like to have 2 tests because honeybadger don't care (HcG and HbA1C)...While I don't think keflex affects the minipill metabolism (or does it?), you can never be too sure, even though she states having a period. And its possible she has an elevated A1c (BMI is 30) which might be some of the issues of pain, swelling, neph etc due to vascular issues? Would a mammogram be in order if she hasn't had one? (mid 30s, fam hx, etc)... Link to comment Share on other sites More sharing options...
Corpsman2PA Posted May 5, 2013 Share Posted May 5, 2013 Additional question...sexually active? Last mammo? I'd really like to have 2 tests because honeybadger don't care (HcG and HbA1C)...While I don't think keflex affects the minipill metabolism (or does it?), you can never be too sure, even though she states having a period. And its possible she has an elevated A1c (BMI is 30) which might be some of the issues of pain, swelling, neph etc due to vascular issues? Would a mammogram be in order if she hasn't had one? (mid 30s, fam hx, etc)... Link to comment Share on other sites More sharing options...
Corpsman2PA Posted May 5, 2013 Share Posted May 5, 2013 Additional question...sexually active? Last mammo? I'd really like to have 2 tests because honeybadger don't care (HcG and HbA1C)...While I don't think keflex affects the minipill metabolism (or does it?), you can never be too sure, even though she states having a period. And its possible she has an elevated A1c (BMI is 30) which might be some of the issues of pain, swelling, neph etc due to vascular issues? Would a mammogram be in order if she hasn't had one? (mid 30s, fam hx, etc)... Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 5, 2013 Author Administrator Share Posted May 5, 2013 Sexual activity was implied by being married, almost a year postpartum, and on appropriate birth control. Mammogram has not been done yet. CBC shows H&H and MCV is a bit on the low side, but not anemic. BUN/Creatinine are are normal. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 5, 2013 Author Administrator Share Posted May 5, 2013 Sexual activity was implied by being married, almost a year postpartum, and on appropriate birth control. Mammogram has not been done yet. CBC shows H&H and MCV is a bit on the low side, but not anemic. BUN/Creatinine are are normal. Link to comment Share on other sites More sharing options...
Administrator rev ronin Posted May 5, 2013 Author Administrator Share Posted May 5, 2013 Sexual activity was implied by being married, almost a year postpartum, and on appropriate birth control. Mammogram has not been done yet. CBC shows H&H and MCV is a bit on the low side, but not anemic. BUN/Creatinine are are normal. Link to comment Share on other sites More sharing options...
tjohn Posted May 5, 2013 Share Posted May 5, 2013 Has the patient recently increased her fluid intake or activity/exercise level? Have her return for an appt. late in the day so that you can truly assess the edema that is being reported. Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.