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-
- Acute Coronary Syndrome
- Aortic Dissection
- Pulmonary Embolism
- Gastroesophageal Disorder
- Urinary Tract Infection
- Acute Pancreatitis
- Musculoskeletal Strain
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.