Weight loss, fatigue, and troubling laboratory findings
Elevated liver enzymes were the first clue to a grave diagnosis.
Diagnosis & Disease Information
Fatigue, pre-syncope, and GI symptoms in a diabetic patient
Weeklong nonspecific symptoms turn out to be early warning signs of a potentially fatal disorder.
A case of first-trimester vaginal bleeding with abdominal cramping
A trip to the emergency department revealed pertinent information used to diagnose an otherwise healthy woman.
Nosy nurse runs afoul of HIPAA rules
Breaching the privacy of a patient’s records could land her in jail and jeopardize the entire clinic.
“Sometimes tragedies just happen”
When a 16-year-old dies after an auto accident, his distraught parents look for someone to blame.
Draining jaw lesion following treatment for a dental abscess
A 63-year-old woman was treated for a dental abscess on her right lower jaw
Purple blotches in an elderly man with atrial fibrillation
An 80-year-old man who complained of recently noted dark purple blotches on the backs of his hands and extensor surfaces of his forearms
Ensuring a steady gaze
If a patient is having difficulty looking ahead at a distant object while you check the pupils, have him or her lie down and stare up at the ceiling. This decreases the effort involved in keeping the neck and shoulder muscles steady.—Geraldine Calandra, APRN-BC, Rochester, N.Y. (120-18)
High BP in a compliant diabetic?
A 71-year-old man with well-controlled type 2 diabetes and no cardiovascular disease has a total cholesterol well below 200 mg/dL and an LDL <100 mg/dL, but his HDL ranges from 20-29 mg/dL. His systolic BP has been elevated (140-160 mm Hg) since age 18, but it drops to the 120s or 130s when taken a…
Vaginal candidiasis in pregnancy
What is the safest/most appropriate treatment for vaginal candidiasis during pregnancy?—Nancy Tosone, MSN, APRN, Omaha, Neb. Vulvovaginal candidiasis is common during pregnancy and does not require treatment unless symptomatic. Vulvovaginal pruritus and soreness are the most common symptoms. The CDC recommends once-daily intravaginal application of imidazoles. There have been no reported cases of fetal abnormalities…
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