Beruflich Dokumente
Kultur Dokumente
Presentation
Course: Endocrinology
Module: Weight Gain/Moon Facie,
Weakness/Hematuria
Presented by:
Bangsaja, Al-Disar B.
Caluang, Calingalan H.
Danial, Katheya S.
Garcia, Ronel Glen S.
Genturalez, Dwight Christian D.
Macabada, Yasmin B.
Maneja, Marco Louie G.
Montalban, PJ-Purple Liz C.
Quimson, Kim Faye E.
Santos, Czerahlee Jaine L.
Group 2
March 11, 2019
Date of Admission: February 20, 2019
Date of Interview: February 25, 2019
Time of Interview: 12:30 PM
Place of Interview: ER Ward, ZCMC
Source of Information: Patient
Reliability: 95%
PERSONAL DATA
FAMILY HISTORY
Strong family history of hypertension was reported on his maternal
side while arthritis and cardiac problems were noted on his paternal side.
There are no other heredofamilial diseases such as asthma, Diabetes
Mellitus, adrenal diseases and cancer.
PERSONAL AND SOCIAL HISTORY
Patient is living together with his common law wife and four (4)
children. He had a previous live in partner and had 1 child with her. He is
non-smoker and admits on drinking alcohol every night with an unrecalled
amount per occasion. He started drinking in the year 2000 and ceased in the
year 2010. His usual meal intake includes rice, dried fish, fish and
vegetables. He spends most of his time at home gardening.
REVIEW OF SYSTEMS
CARDIOVASCULAR (+) palpitations (-) pleuritic chest pain or discomfort (-) Chest
pain
GASTROINTESTINA (-) nausea and vomiting (-) loss of appetite (-) diarrhea (-)
L constipation
(-) rectal bleeding (-) abdominal pain
URINARY (-) dysuria (-) hematuria (-) discharges (-) polyuria (-) nocturia
(-) kidney or flank pain
PERIPHERAL (-) leg cramps (-) tingling sensations (-) varicose veins (-) past
VASCULAR. clots in the veins
PHYSICAL EXAMINATION
Height-5’4
Weight-56 kg (2017)
BMI- 21.3
Weight-76kg (2019)
BMI- 28.7 (Overweight)
Extremities:
Brittle nails
Edema on lower extremities (62%)
Essential hypertension
History: Physical Exam:
Prevalence of 90% V/S: BP – 160/100 mmHg
Family History – maternal side
Diagnosed with hypertension
since 2010
Occasional headaches and
lightheadedness
Palpitations
Nape Pain
Infected wound
DIFFERENTIAL DIAGNOSIS:
Dx Rule-in Rule-out
bipedal edema
*kidney disorder
MANAGEMENT
1. Admit to ward
2. Pharmacologic:
a) Cushing’s – oral agents
i. metyrapone – 500mg TID maximum 6g/day
ii. and ketoconazole- 200mg TID maximum 1200mg/day
b) Antihypertensive
i. ACE inhibitors (Captopril 6.25-50mg OD)
ii. ARBS (Losartan 25-100mg OD) – if ACE intolerant
b. Anti- Gout: Colchicine - 1mg loading dose within 12 hrs. followed
by 1 hour later until flare subside