- CDC
- Heart Failure
- Cardiovascular Clinical Consult
- Adult Immunization
- Hepatic Disease
- Rare Disorders
- Pediatric Immunization
- Implementing The Topcon Ocular Telehealth Platform
- Weight Management
- Monkeypox
- Guidelines
- Men's Health
- Psychiatry
- Allergy
- Nutrition
- Women's Health
- Cardiology
- Substance Use
- Pediatrics
- Kidney Disease
- Genetics
- Complimentary & Alternative Medicine
- Dermatology
- Endocrinology
- Oral Medicine
- Otorhinolaryngologic Diseases
- Pain
- Gastrointestinal Disorders
- Geriatrics
- Infection
- Musculoskeletal Disorders
- Obesity
- Rheumatology
- Technology
- Cancer
- Nephrology
- Anemia
- Neurology
- Pulmonology
Shortness of Breath, Pallor in a 41-Year-Old Man: Next Steps?
These presenting symptoms began after a near syncopal episode. The patient has no significant medical or surgical history. More details, here.
A 41-year-old man presents with shortness of breath and weakness after a near syncopal episode earlier in the day. He appears pale and mildly dyspneic. He denies chest pain, cough, or fever. He has no cardiac risk factors and denies any significant past medical or surgical history. He takes no medications, has no known allergies and denies the use of tobacco, alcohol, or recreational drugs.
Vital Signs:
Temp: 98.1°F (36.7°C)
HR: Initially 168 beats/min when ambulatory, dropping to 126 after 10 minutes of rest, but suddenly increases to 154 upon standing
RR: 30 breaths/min when ambulatory, 22 at rest
BP: 108/76 mm Hg supine, but drops to 86/60 upon standing
02 Sat: 98% on room air
Physical examination:
Cardiopulmonary: clear lungs and a normal cardiac examination without murmurs
Abdominal: soft, non-tender and non-distended
Skin: pale and dry with conjunctival pallor
Questions
1. What else should you look for?
2. What should be included in your differential diagnosis?
3. What is your next step?
Clinical Tips for Using Antibiotics and Corticosteroids in IBD
January 5th 2013The goals of therapy for patients with inflammatory bowel disorder include inducing and maintaining a steroid-free remission, preventing and treating the complications of the disease, minimizing treatment toxicity, achieving mucosal healing, and enhancing quality of life.
