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Old 12-14-2012
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Question What's your Diagnosis?

Patient is a 75 year old female with a longstanding history of R hemiparesis, who is a resident of a local nursing home, is admitted to the hospital with a temperature of 103 F. She has also exhibited a decreased mental status over the last several days along with a cough noted during oral feedings. Her past medical history is significant for osteoporosis, Parkinson’s disease and thrombocytopenia. She has no history of pulmonary problems but has a history of borderline HTN which has been controlled by Aldomet. Her other medications include Synthroid.

She is very frail appearing and lethargic. She is tachypneic with a RR = 300. Her HR = 100 bpm and her BP = 120/70. Her posture is kyphotic. She has difficulty following commands. Auscultation demonstrates bronchial breath sounds at the R base. CXR revealed an area of consolidation at the R middle lobe. Her ABG’s are
7.39/42/27/55. What's your diagnosis ?
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Old 12-14-2012
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Lobar pneumonia secondary to oropharyngeal aspirate
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Old 12-14-2012
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yes....lobar pneumonia with delirium(altered mental status)
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Old 12-15-2012
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where are forum masters..? waiting for more response !
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Old 12-15-2012
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Ya same for me Rt middle lobe Aspiration pneumonia complicated by Atelectasis and delirium
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Old 12-16-2012
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Quote:
Originally Posted by sohailus View Post
Patient is a 75 year old female with a longstanding history of R hemiparesis, who is a resident of a local nursing home, is admitted to the hospital with a temperature of 103 F. She has also exhibited a decreased mental status over the last several days along with a cough noted during oral feedings. Her past medical history is significant for osteoporosis, Parkinson’s disease and thrombocytopenia. She has no history of pulmonary problems but has a history of borderline HTN which has been controlled by Aldomet. Her other medications include Synthroid.

She is very frail appearing and lethargic. She is tachypneic with a RR = 300. Her HR = 100 bpm and her BP = 120/70. Her posture is kyphotic. She has difficulty following commands. Auscultation demonstrates bronchial breath sounds at the R base. CXR revealed an area of consolidation at the R middle lobe. Her ABG’s are
7.39/42/27/55. What's your diagnosis ?
Aspiration pneumonia due to loss of gag reflex. patient should be evaluated with barium swallow studies.If patient fail swallow study peg tube should be offered while patient continue to be on therapy. The AMS is due to hypoxia and fever.
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Old 12-16-2012
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my dx is probably septisemia due to aspiration pnemonia...

Last edited by online; 12-16-2012 at 11:45 PM.
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