Case #27
William Jordan, a 61-year-old male, comes to to the office complaining of fatigue.
BP: 135/85 mm Hg
Temp: 98.6°F (37°C)
RR: 13/minute
HR: 70/minute, regular
Diagnosis #1: Pancreatic cancer
Diagnosis #2: Major depressive disorder
Diagnosis #3: Chronic pancreatitis
- CBC with differentials, stool for occult blood
- Glucose
- Fecal fat studies
- Amylase, lipase
- AST/ALT/Bilirubin (direct, indirect, and total)/Alkaline phosphatase
- CT-abdomen
Case #33
Gary Mitchell, a 46-year-old male, comes to the office complaining of fatigue.
BP: 120/85 mm Hg
Temp: 98.2°F (36.8°C)
RR: 12/ minute
HR: 65/minute, regular
Diagnosis #1: Major depressive disorder
Diagnosis #2: Hypothyroidism
Diagnosis #3: Posttraumatic stress disorder
- TSH
- CBC
- Serum chemistry panel
- HIV antibody
Case #34
Jessica Lee, a 32–year-old female, comes to the office complaining of fatigue.
BP: 120/85 mm Hg
Temp: 98.2 °F (36.8° C)
RR: 13/minute
HR: 80/minute, regular
Diagnosis #1: Domestic violence
Diagnosis #2: Diabetes mellitus
Diagnosis #3: Anemia
- Serum glucose, HbA1c
- CBC
- Serum iron, ferritin, TIBC, serum 812
- UA
- Electrolytes
Case #32
Virginia Blade, a 6 yo comes to the clinic complaining of forgetfulness and confusion.
BP: 135/85 mm Hg
Temp: 98.0 °F (36.7° C)
RR: 16/minute
HR: 76/minute, regular
Diagnosis #1: Alzheimer disease
Diagnosis #2: Vascular dementia
Diagnosis #3: Depression with pseudodementia
- CT head or MRI brain
- EEG or SPECT
- CBC with differential
- Serum B-12, TSH, RPR
- Electrolytes, calcium, glucose, BUN/Cr
Case #35
Jade Edwards, a 27 yo male, comes to the ED complaining of seeing strange writing on the wall.
BP: 140/80 mmHg
Temp: 98.3 °F (36.5 °C)
RR: 15/minute
HR: 110/minute, regular
Diagnosis #1: PCP intoxication
Diagnosis #2: Substance-induced psychosis
- Urine toxicology
- Electrolytes
- CPK
- Urine myoglobin
- Mental status exam
Gwen Potter, a 20 yo female, comes to the clinic complaining of sleeping problems.
BP: 120/80 mm Hg
Temp: 98.6 °F (37 °C)
RR: 18/minute
HR: 102/minute
Diagnosis #1: Generalized Anxiety Disorder
Diagnosis #2: Caffeine-induced insomnia
Diagnosis #3: Hyperthyroidism
- TSH, T3, T4
- CBC with differentials
- Urine toxicology
- Polysomnography
- ECG
