Table 1. Patient’s list of home medications before admission
She denied any alcohol or recreational drug use. She quit smoking a few years back. Her mother had a history of myocardial infarction, diabetes mellitus, hypertension, and Rheumatoid arthritis. Her family is originally from Mexico, and one of her brothers and her two cousins have elevated triglycerides.
Physical examination was significant for tenderness in the epigastric and bilateral costovertebral area. Her abdomen had disproportionatelyincreased fat deposition while her arms and legs were skinny (due to lipodystrophy).
Her blood pressure was 125/89 mm Hg, heart rate was 140 bpm, temperaturewas 36.3 C, and respiratory rate was 17 breaths/ minute.
The differentials based on her symptoms and physical examination included-
Her CBC showed a WBC count of 11.2 K/mm3 with neutrophilic predominance (reference range 4-11 K/mm3), Hb of 13.4 g/dL (reference range 12-16 mg/dL), Hematocrit of 40% (reference range 35-48%) and a platelet count of 258 K/mm3 (reference range 130-450 K/mm3). Her urinalysis revealed the presence of blood and 3-10 RBCs/hpf. Other pertinent lab results are shown in Table2.