70 year old female presented to the ER with severe epigastric
pain, she is diabetic and is on anti-ischemic medications and
ranitidine for gastritis. The doctor discharged her on a proton
pump inhibitor. The second day she returned with persistent
epigastric pain.
DD
HistoryImportant Qs
HistoryCharacter of pain, referral, ppt factor
ExaminationEpigastric tenderness
Investigations
InvestigationsECG, cardiac enzymes, CBC
A 70 year old male presented to the clinic with left shoulder
pain. He is an ex-smoker, hypertensive diabetic, CLD, ischemic
heart disease, knee osteoarthritis
DD
HistoryImportant Qs
HistoryHypertensive for 30 years on ACEi with regular Fup and
controlledDiabetic for 30 years on oral antidiabetic with regular
Fup and controlledISHD with previous catheter after MI 9stopped
heavy smoking) on aspocid 75mg, anti-ischemic medicationCLD, Hep C
+, compensatedLeft shoulder pain in left side of the neck and
shoulder , vague character, not referred, precipitated by carrying
his grocery bags, cant associate a relieving factor.
ExaminationImportant signs?
ExaminationShoulder examination: freeNeurological examination:
hyperthesia left arm with dermatomal distribution, glove and stock
hypothesia.
