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Discussion

Does anyone remember this?

When I first joined allnurses, last September, there were threads where the OP would describe a patient's presentation, list symptoms, etc People who replied theorized on what the dx might be. It took me a while to activate my membership, and I've never seen one of those threads again.

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I do remember that.

renerian

Wasn't there then. But why wouldn't you know what the dx was if you were a nurse?

You wouldn't necessarily know, because so many signs and symptoms can mean multiple things.

I remember them though. Didn't Gwenith post a lot of them? Me and my faulty memory.

-54 yr old female

-presents to ER w/ complaint of facial/tongue swelling. No pain. Afebrile. B/P 130/78

pulse-100,strong and regular.Resps 20,even & unlabored. Appears anxious.

-states she just woke up like that; was fine before she went to bed last night.

-no history or evidence of bug bite.

-Medical History:

NIDDM

HTN

-Medications:

Glipizide

Lisinopril

What is going on here?

(Is this anything like you were thinking?)

Angioedema as a side effect of ACE inhibitor Lisinopril? I like these "case studies", too.

  • Author
-54 yr old female

-presents to ER w/ complaint of facial/tongue swelling. No pain. Afebrile. B/P 130/78

pulse-100,strong and regular.Resps 20,even & unlabored. Appears anxious.

-states she just woke up like that; was fine before she went to bed last night.

-no history or evidence of bug bite.

-Medical History:

NIDDM

HTN

-Medications:

Glipizide

Lisinopril

What is going on here?

(Is this anything like you were thinking?)

Yes, exactly!!!

I've had 2 of these cases recently. One lost her airway and we bagged her reaalllly hard for awhile, along with steriods, etc. and she was okay, but really scarey!

Here's one that stumped us...

32 y/o female

S/S

Abdominal pain, starts just below ribs on both sides, similar to menstrual cramps but pain unrealted to cycle...

Pain starts after eating starchy foods like bread...

Pain radiates to back a little below the axillary level...

Vitals T-100.8 P-108 R-16 B/P-150/100...

CBC, Chem-20, Amylase, Lipase, UA all WNL...

Negative gall bladder ultrasound, HIDA scan WNL - EF "high side of normal"

Medical History - T&A @ age 13, lady partsl delivery @ age 20, C-section x2 @ age 22 and 27...

Family History - Father with diabetes, Mother with pancreatic pseudocysts, sister with Raynaud's

No allergies...

Meds - Lexapro 10 mg daily

No pain relief with GI cocktail, no relief with Morphine 10 mg, no relief with Demerol 50 mg, good pain relief with Toradol 15 mg IM...

Negative EGD

Negative colonoscopy

That's about all I can remember...patient was in ER several times and we never saw her after she was refered to a surgeon...

I looked for the other thread. No can find. Maybe someone else can. I remember the thread. It was quite interesting reading the other posts as well. Sorry I couldn't help more!

  • Experts
Here's one that stumped us...

32 y/o female

S/S

Abdominal pain, starts just below ribs on both sides, similar to menstrual cramps but pain unrealted to cycle...

Pain starts after eating starchy foods like bread...

Pain radiates to back a little below the axillary level...

Vitals T-100.8 P-108 R-16 B/P-150/100...

CBC, Chem-20, Amylase, Lipase, UA all WNL...

Negative gall bladder ultrasound, HIDA scan WNL - EF "high side of normal"

Medical History - T&A @ age 13, lady partsl delivery @ age 20, C-section x2 @ age 22 and 27...

Family History - Father with diabetes, Mother with pancreatic pseudocysts, sister with Raynaud's

No allergies...

Meds - Lexapro 10 mg daily

No pain relief with GI cocktail, no relief with Morphine 10 mg, no relief with Demerol 50 mg, good pain relief with Toradol 15 mg IM...

Negative EGD

Negative colonoscopy

That's about all I can remember...patient was in ER several times and we never saw her after she was refered to a surgeon...

My guess is abdominal migraine-vs-pancreatic spasms.
Here's one that stumped us...

32 y/o female

S/S

Abdominal pain, starts just below ribs on both sides, similar to menstrual cramps but pain unrealted to cycle...

Pain starts after eating starchy foods like bread...

Pain radiates to back a little below the axillary level...

Vitals T-100.8 P-108 R-16 B/P-150/100...

CBC, Chem-20, Amylase, Lipase, UA all WNL...

Negative gall bladder ultrasound, HIDA scan WNL - EF "high side of normal"

Medical History - T&A @ age 13, lady partsl delivery @ age 20, C-section x2 @ age 22 and 27...

Family History - Father with diabetes, Mother with pancreatic pseudocysts, sister with Raynaud's

No allergies...

Meds - Lexapro 10 mg daily

No pain relief with GI cocktail, no relief with Morphine 10 mg, no relief with Demerol 50 mg, good pain relief with Toradol 15 mg IM...

Negative EGD

Negative colonoscopy

That's about all I can remember...patient was in ER several times and we never saw her after she was refered to a surgeon...

~~

did she ever have a c reactive protein drawn?

was it up?

and 1 more ?

did she get a cat c gastrographin?

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