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Presentationaug2011
1. 59y old male with PMH of DM last Hba1c 6.2 in July , HTN, pulmonary HTN, OSA on CPAP, CKD (nephrotic syndrome) , CHF, EF: 67% presents with right leg swelling Vitals in ER T: 97.7 BP: 183/88 HR: 88 RR: 16 Sao2: 97% on room air
2. GE: well oriented to time ,place and person ,lying on the bed does not seem to be in acute distress CVS: S1, S2 RRR, No Murmurs, PMI not displaced LUNGS: Air movement equal bilaterally, No wheezes or creptitations, P/A: BS+ before palpation, soft, NT, ND, No rebound tenderness, no OM , CNS: A&OX 3, No focal deficit, gaits normal. EXT: No edema, pulses palpable., right leg: edema 2+ upto the knee, erythema and tender , no changes in left leg