robin082006
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Topics: 471
Posts: 5,125
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A 64-year-old Caucasian male presents to the Emergency Room with a sharp, left-sided chest pain. He says that the pain is worse when he takes deep breaths, but he gets relief with leaning forward. He had an acute non-ST elevation myocardial infarction six months ago and had undergone angioplasty for the right coronary artery. His other medical problems include: diabetes, hypertension, hyperlipidemia, peripheral neuropathy, diabetic retinopathy, paroxysmal atrial fibrillation, hypothyroidism, and chronic renal insufficiency. His vital signs are: BP 142/86 mmHg, PR 78/min, RR 16/min, and T 36.1C (97F). On examination, you find a pericardial rub. EKG shows diffuse ST elevation. Lab results are:
Hb
9.0 g/dL
WBC
8,000/cmm
Platelets
210,000/cmm
Blood Glucose
248 mg/dL
Serum Na
135 mEq/L
Serum K
5.8 mEq/L
Bicarbonate
17 mEq/L
BUN
86 mg/dL
Serum Creatinine
4.4 mg/dL
Which of the following is the most appropriate management of this patient?
A. NSAIDs
B. Corticosteroids
C. Pericardiocentesis
D. Hemodialysis
E. nitrates
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The Key to Succeed is Patience.
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| MDcooper
Forum Guru
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what is the source robin?
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live and let live.
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| Aashi
Forum Moderator
Topics: 113
Posts: 1,060
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Uremic pericarditis--->indication for hemodialysis---->D
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| Guptashutosh
Forum Elite
Topics: 35
Posts: 354
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yeah symptomatil uremiic shd under go dialysis
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