Endocrine, Hematologic, & Metabolic Disorders

Case Study

An 82-year-old female presents to the office complaining of fatigue, dizziness, weakness, and increasing

dyspnea on exertion. She has a past medical history of atrial fibrillation, hypertension, and hyperlipidemia.

Medications include warfarin 2 milligrams po daily, lisinopril 10 milligrams po daily, and simvastatin 10 milligrams

po daily. There are no known drug allergies. The physical exam reveals a 5'2” older female. Her weight is 128

pounds, blood pressure is 144/80, heart rate is 98, temperature is 98 degrees Fahrenheit, and O2 saturation is

98%. Further examination reveals the following:

Eyes: + pallor conjunctiva

Cardiac: irregular rhythm. No S3 $4 or M. NO JVD

Lungs: CTA wio rales, wheezes, or rhonchi

Abdomen: soft, BS +, + epigastric tenderness. No organomegaly, rebound, or guarding

Rectal: no stool in rectal vault

  1. List the primary diagnosis
  2. List at least 3 differential diagnosis with a brief rational
  3. Describe the pertinent history required to rule in or rule out
  4. Describe your physical exam findings or screening tools used
  5. Discuss the treatment plan for the patient in your case study using this format

Sample Solution