A 65-year-old African-American woman presented to the emergency room complaining of worsening shortness of breath and palpitations for about 1 week. She reports feeling "dizzy" on and off for the past year; the dizziness is associated with weakness that has been worsening for the past month. She has been feeling "too tired" to even walk to her backyard and water her flower bed that she used to do "all the time." She has been so dyspneic walking up the stairs at her home that she moved downstairs to the guest room about a week ago. Review of systems is significant for knee pain, for which she frequently takes aspirin or ibuprofen; otherwise the review of systems is negative. She has no significant medical history and has not been to a doctor in several years.

 

She had a normal well-woman examination and screening colonoscopy about 5 years ago. She occasionally has an alcoholic drink and denies tobacco or drug use. She is married and is a retired shopkeeper. On examination, her blood pressure is 150/85 mm Hg; her pulse is 98 beats/min; her respiratory rate is 20 breaths/min; her temperature is 98.7 degrees; and her oxygen saturation is 99% on room air. Significant findings on examination include conjunctival pallor, milk tenderness with deep palpation in the epigastric and left upper quadrant region of the abdomen with normal bowel sounds, and no organomegaly but positive stool guaiac test. The remainder of the examination, including respiratory, cardiovascular, and nervous systems, was normal. 

 

Be sure to listen until the end when I will be presenting four questions with multiple choice answers and check back on Friday to the May's Anatomy Podcast instagram page for the answers! 

 

Episode 67: Next Steps as a New Grad Nurse Practitioner with Alicia Akamine, FNP-BC

 

Episode 57: Discussing Body Mass Index and it's Validity in the Healthcare Setting with Chase Chewning, ACE Certified Health Coach

 

Case Files: Family Medicine

 

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