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Kali Hartt
Primary Care Internal Medicine
Week 3

12-2-13
Today I rounded with Dr. Malik, Dr. Gunther, and Dr. Methe. One patient I had
the chance to observe was a ninety-two year old male who had an atrial hematoma. A
hematoma in general is a collection of clotted blood outside the blood vessels and in the
tissue. An atrial hematoma is, in simpler terms, a pool of blood surrounding a portion of
the heart. The doctors were very concerned that this hematoma showed up considering
the patient had no sign of an accident. Hematomas are usually caused by a type of
trauma. If a trauma hasnt occurred, blood thinners as well as diseases could be the
cause of one.
This condition is however very serious so the patient was transferred to the ICU;
the intensive care unit. The ICU could keep a better eye on him in order to figure out
what the next step in the process was going to be.
References:
"Hematoma Symptoms, Causes, Treatment - What causes a hematoma? -
MedicineNet." MedicineNet. N.p., n.d. Web. 2 Dec. 2013.
<http://www.medicinenet.com/hematoma/page2.htm#what_causes_a_hematoma>.

12-3-13
While in PCIM this morning, we visited the intensive care unit to follow up with
one of our patients. This patient was a thirty eight year old male who was admitted
because of severe pneumonia. Pneumonia is an inflammatory condition of the lungs. It
can cause cough, difficulty breathing, and a fever. Along with pneumonia, this patient
also had Wegeners disease.
Wegener's granulomatosis is a rare disorder that causes inflammation of the
blood vessels. This inflammation restricts blood flow to various organs. As of now, there
is no known cause of Wegeners disease. Early diagnosis and treatment of Wegener's
granulomatosis can lead to full recovery. Without treatment, Wegener's granulomatosis

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can be fatal; most commonly from kidney failure.
On top of these two health problems, the patient was a frequent alcohol drinker.
He developed cirrhosis. Cirrhosis is a slowly progressing disease where healthy liver
tissue is replaced with scar tissue. Eventually this prevents the liver from functioning
properly. The scar tissue blocks the flow of blood through the liver and slows the
processing of nutrients, hormones, drugs, and naturally produced toxins.
References: "Definition." Mayo Clinic. Mayo Foundation for Medical Education and
Research, 19 Dec. 2012. Web. 3 Dec. 2013.
<http://www.mayoclinic.com/health/wegeners-granulomatosis/DS00833>.

12-4-13
No Internship

12-5-13
A patient that I saw earlier in the week had all kinds of unfortunate health
problems. Dr. Malik discussed with him today that he was hypokalemic. Hypokalemia is
a deficiency of potassium in the bloodstream. Too little as well as too much potassium
in the body can cause serious problems. Potassium is an electrolyte that is critical to the
proper functioning of nerve and muscles cells, especially the heart muscle cells. A
common cause of low potassium is excessive potassium loss in urine. However, this
patient is a severe alcoholic. Alcohol abuse causes hypokalemia through a combination
of poor diet, vomiting, and/or concomitant magnesium depletion. To help treat this
particular health problem Potassium Chloride was administered.
References:
https://www.clinicalkey.com/topics/nephrology/hypokalemia.html