• Share
  • Email
  • Embed
  • Like
  • Save
  • Private Content
Abd Pain ER Case Presentation
 

Abd Pain ER Case Presentation

on

  • 3,004 views

 

Statistics

Views

Total Views
3,004
Views on SlideShare
2,999
Embed Views
5

Actions

Likes
0
Downloads
26
Comments
0

1 Embed 5

http://www.slideshare.net 5

Accessibility

Categories

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

    Abd Pain ER Case Presentation Abd Pain ER Case Presentation Presentation Transcript

    • Abdominal Pain: A Case Presentation Erik Manninen, CPT, MC PGY-1 Internal Medicine
    • History
      • CC: Abdominal pain and worsening agitation/mental status x 5 days
      • HPI: 85yo WM with diffuse abd. pain for 5 days, increased urinary frequency, and worsening mentation at night.
      • PMH: BPH and dementia.
      • PSH: ?
      • All: NKDA
      • Meds: Detrol and ambien started one week PTP.
    • Exam
      • VSSAF
      • 8cm diameter suprapubic mass TTP
      • Right CVAT
      • CV: RRR no m/r/g
      • Lungs: CTAB
    • Differential Diagnosis
      • AAA
      • Mesenteric ischemia
      • MI
      • Perforated peptic ulcer
      • Obstruction
      • Pancreatitis
      • Diverticulitis
      • Nephrolithiasis
      • Acute cholecystitis
      • Appendicitis
      • Gastroenteritis
      • Non-ulcer dyspepsia/PUD
      • UTI/Pyelonephritis
    • Labs
      • Cr 3.6
      • Nl CBC, LFTs
      • Blood cx sent
    • Ancillary
      • EKG with NSR
      • Renal/bladder US with right hydronephrosis and thin renal cortices consistent with CRD
    • Intervention
      • Foley catheter drained 2500cc dark amber colored urine with gross hematuria near end of void with resolution of suprapubic mass.
      • Discontinuance of detrol/ambien.
      • Admission and monitoring of electrolytes along with fluid replacement for post-obstructive diuresis.
    • Outcome
      • Pt.’s Cr improved to 1.8
      • Pt. Managed by IM with urology consult.
        • Started on proscar (finasteride) and flomax (tamsulosin).
      • MS changes attributed to sundowning, given haldol on cross-cover.