commit b4ba09951431e8d878810a0e39492ea18ddcc1c8
parent c7e00a7c42553ba2946651e412f06e02a3236801
Author: Beau Hilton <beau.hilton@vumc.org>
Date: Sun, 22 Aug 2021 13:31:53 -0500
add image
Diffstat:
1 file changed, 12 insertions(+), 10 deletions(-)
diff --git a/posts/mr-2021.md b/posts/mr-2021.md
@@ -9,7 +9,7 @@ Details modified, generalized, and otherwise fudged to be HIPAA-compliant.
## HPI
-70F with chest pain, abdominal pain, and constipation.
+72F with chest pain, abdominal pain, and constipation.
2-3mo weight loss, night sweats.
@@ -21,17 +21,23 @@ Details modified, generalized, and otherwise fudged to be HIPAA-compliant.
+LUQ and left-sided chest pain x1-2 days, radiates to L arm, not related to exertion, lasts a few minutes.
+## OP Meds
+- duloxetine 60mg
+- ASA 81mg
+- melatonin 6mg
+- no notable allergies
## PMSHx
- TVH-BSO for fibroids and endometriosis (~20y ago)
- hemorrhoids (no surgeries)
- s/p Moderna COVID vaccine (~4wk ago)
-- utd on mammograms, colonoscopies, no deviations from regular schedule
+- UTD on mammograms, colonoscopies, no deviations from regular schedule
## SHx
- monogamous x45y, G2P2 sons, 6yo grandson, all healthy
- never smoker
- social EtOH, none this year
+- no non-Rx medicines
- previously secretary
- likes to DIY: painting, home crafts, gardening
@@ -39,12 +45,6 @@ Details modified, generalized, and otherwise fudged to be HIPAA-compliant.
- M GM: uterine cancer (~40yo)
- P GF: lung ca, unknown type (~70yo)
-## OP Meds
-- duloxetine 60mg
-- ASA 81mg
-- melatonin 6mg
-- no notable allergies
-
## PE
- VS: wnl
- GEN: NAD
@@ -62,7 +62,7 @@ Details modified, generalized, and otherwise fudged to be HIPAA-compliant.
- 0 atypical lymphs
- + slight L shift
- Plt 490
-- BMP grossly wnl (gluc 202)
+- BMP grossly wnl (gluc 202, [Cr fine](https://www.ashclinicalnews.org/viewpoints/editors-corner/illegitimi-epic-non-carborundum-dont-let-epic-bastards-grind/))
- LFTs fine
- Trop <0.01
- urate 10.4
@@ -89,11 +89,13 @@ Details modified, generalized, and otherwise fudged to be HIPAA-compliant.
- JAK2 -ve, BCR/ABL -ve
## TLS
+
+[![JAMA Oncology TLS graphic][https://cdn.jamanetwork.com/ama/content_public/journal/oncology/937239/cpg180002fa.png][https://jamanetwork.com/journals/jamaoncology/fullarticle/2680750]]
+
- laboratory vs clinical
- risk assessment
- rasburicase
- allopurinol
-- when to expect
## MDS/MPN overlap syndromes
- something profound
