Larry is a 77-year-old male who has a history of HTN, restless ...

[ashley]

Larry is a 77-year-old male who has a history of HTN, restless leg syndrome, DVT, and essential tremor. He presented to the hospital complaining of bloody diarrhea and LLQ pain. He also c/o nausea. He is dehydrated. CT scan of the abdomen showed diverticular disease of the ascending colon with a likely abscess. Hgb and Hct were low normal, though there are concerns they could go lower once he is rehydrated. The patient is being admitted for antibiotic treatment and rehydration. Will address any other concerns as needed.
 
  Admitting diagnoses: Diverticulitis with abscess and hemorrhage; HTN, restless legs syndrome, history of DVT on Coumadin; essential tremor.
 
  What will be an ideal response?

Question 2

John is a 36-year-old Asian male who was admitted to the hospital after complaining of significant LUQ pain that radiates to the left flank. He indicated the pain was constant and worse when he lies down. He has also had occasional vomiting over the last three days. Initially, it was thought he may have a kidney stone, but further testing and labs proved otherwise. He is being discharged from this critical access hospital and transferred to a tertiary medical center up north.
 
  His physical exam showed abdominal distention, increasing LUQ pain on palpation. Sclera were jaundiced.
 
   Labs: serum amylase and lipaseextremely elevated.
 
   CT of abdomen with contrast showed peripancreatic inflammation and fluid.
 
  What will be an ideal response?
 
   Impression: Acute pancreatitis vs. pancreatic pseudocyst

[Galvarado142]

Answer to Question 1

Answer: Diverticulitis with abscess and bleedingK57.21
HTNI10
Restless legs syndromeG25.81
Essential tremorG25.0
History of DVTZ86.72
Long term use of CoumadinZ79.01

Answer to Question 2

Answer: Acute pancreatitisK85.9
Pancreatic pseudocystK86.3

Either diagnosis can be sequenced first.