year old []male presented with hematemesis for [] days, up to a []. Denies[] abdominal pain.
Hematemesis - Differential diagnosis includes gastric ulcer and esophageal varices. Risks/benefits of EGD with possible variceal banding discussed with patient[] including bleeding, infection, perforation, and death. Patient agreeable to proceed with upper endoscopy.
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"The American Society for Gastrointestinal Endoscopy (ASGE) acknowledged that the minimal platelet threshold for endoscopy has not been established[1]. In 2012, based on limited data[2-4], ASGE guidelines concluded that a platelet level of 20000/mm3 or greater can be used as a threshold for performing diagnostic upper endoscopies, but a threshold of 50000/mm3 may be considered before performing biopsies" ...Read more | Endoscopy in neutropenic and/or thrombocytopenic patients
[] year old female presented with epigastric[] pain for [] days, non-[]radiating, []worse with eating. Associated nausea/vomiting, fever, and chills[]. This is a template for a typical presentation of choledocholithiasis, which can be confirmed with an MRCP. The template is designed for Meditech. Treatment is with an ERCP with stone removal. ...Read more
Dyspepsia - < 55 year old, low-risk patient with no alarm features, the first-line therapy: antisecretory therapy for 4-8 weeks
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year old []male presented with hematemesis for [] days, up to a []. Denies[] abdominal pain.
Hematemesis - Differential diagnosis includes gastric ulcer and esophageal varices. Risks/benefits of EGD with possible variceal banding discussed with patient[] including bleeding, infection, perforation, and death. Patient agreeable to proceed with upper endoscopy.
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Stelera had a 65 percent remission rate at one year for Crohn’s disease.
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[] year old []male presented with [] for [] days [] radiates to the []
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[] year old male presented with epigastric abdominal pain for [] days, radiates [], []worse with eating. Associated nausea/vomiting.
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[] year old presents with dysphagia to []solids []liquids for [] months. Points to []xyhpoid. [] weight loss.
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HPI: 57 year old female presented with epigastric abdominal pain, nausea and vomiting.
Past Medical History: Diabetes mellitus
Medications: Lantus
Allergies:
Family History: No history of colon cancer
Social History: 1 pack of cigarettes per day
Review of Systems: heartburn, constipation
Physical Exam: Epigastric tenderness
Labs/Radiology/Procedures: Normal abdominal x-ray
Assessment/Plan: EGD
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<p>HPI: 57 year old female presented with epigastric abdominal pain, nausea and vomiting. <p>Past Medical History: Diabetes mellitus<p>Medications: Lantus<p>Allergies: <p>Family History: No history of colon cancer<p>Social History: 1 pack of cigarettes per day<p>Review of Systems: heartburn, constipation<p>Physical Exam: Epigastric tenderness<p>Labs/Radiology/Procedures: Normal abdominal x-ray<p>Assessment/Plan: EGD to evaluate for gastric outlet obstruction. If no gastric outlet obstruction, then gastric emptying study to evaluate for diabetic gastroparesis.
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HPI: 58 year old male with intermittent chest pain
Past Medical History: Diabetes mellitus, high cholesterol, obesity, hypertension, cholecystectomy
Medications: Lantus, lisinopril, lipitor
Allergies:
Family History: Brother with colon cancer
Social History: 1 pack of tobacco per day
Review of Systems: intermittent dyspnea
Physical Exam: normal
Labs/Radiology/Procedures: Total cholesterol 230
Assessment/Plan: EKG, troponin, stress test, possible cardiac cath. Consult cardiologist.
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