April 5th 2024
More than 1 in 10 older adults were misdiagnosed with community-acquired pneumonia and nearly all were treated with a full course of antibiotics, a new study found.
Elderly Woman With Simultaneous Deep Venous and Arterial Thrombosis
January 8th 2013This patient had unilateral petechiae on the dorsum of the left foot. If the petechiae were symmetric, the first condition on the differential diagnosis would be thrombocytopenia. Here, though, the platelet count was normal. The patient also had a duplex of both the arterial and venous systems that showed complete thrombosis of both the arterial AND venous systems.
Pressure Sore on an Elderly Patient’s Heel
January 8th 2013The patient has a stage 1 decubitus ulcer on her left heel. Both feet are cool but are the same temperature. Distal pulses are palpable but weak on the good foot; they are not palpable on the left and can only be heard faintly with a handheld Doppler. You note unilateral petechiae on the dorsum of the left foot.
Post-traumatic Subcutaneous Hematoma
November 9th 2012This large bruise developed after the patient had an accident in her yard. Post-traumatic subcutaneous hematomas are common in elderly women, especially those who are anticoagulated. Untreated, the hematoma can eventuate into an abscess and even sepsis.
Diabetes Quiz: A 79-Year-Old With Elevated AlC Who Has Had a Stroke: How Would You Treat?
May 1st 2012The elderly patient has had type 2 diabetes for 15 years is now home bound after a stroke. Her HbA1c is 9.6 and she takes only metformin. Review the rest of her laboratory results and propose a management plan.
An Elderly Woman With IgA Lambda Multiple Myeloma and Kidney Disease
A 92-year-old woman presented with a 6-month history of progressively worsening fatigue, weight loss, generalized bone pain, and dyspnea on exertion. A skeletal survey found lytic lesions in the pelvis, sacrum, and calvarium (shown here).
An Elderly Man With a Lung Mass and Neurologic Symptoms
September 28th 2011A 71-year-old man was admitted to the MICU for weaning from mechanical ventilation. The history revealed a global decline over the previous 3 to 4 weeks predominated by cognitive impairment, mood swings, somnolence, and limb weakness. No respiratory symptoms were noted.
Older Man With Visual Symptoms of Acute Onset
May 5th 2010For more than a week, a 74-year-old man has had diminished vision in his left eye. He reports that the problem started acutely with a sensation of flashing lights in the affected eye, followed by the presence of dark floaters for several days.
The Case for Continued Breast Cancer Screening in Older Women
May 4th 2010Dr Mara Schonberg does an excellent job of presenting the pros and cons of continued breast cancer screening in elderly women and of explaining why the current guidelines are vague. My purpose here is not to take issue with anything that she presented, but to make some additional points in favor of continuing breast cancer screening into a woman's "golden" years.
Too Much for the Computer: Complete Heart Block in an Elderly Woman
February 16th 2010A 92-year-old woman presented with signs and symptoms of heart failure, including marked bilateral lower extremity edema, jugular vein distention, and difficulty in breathing at rest. Her medical history was significant for hyperthyroidism, chronic asthmatic bronchitis, and senile dementia. Medications included oral methimazole, 10 mg/d, and oral theophylline, 200 mg/d.
Skin Disorders in Older Adults: Vascular, Lymphatic, and Purpuric Dermatitides, Part 2
July 10th 2009All elements of the skin are affected by age. In this 2-part article, I discuss how the blood vessels, the lymphatics, and the ground substance- which surrounds these vessels- respond to age, and I show how the aging elements of the vasculature can engender a variety of pathological cutaneous conditions.