Most Difficult Case Conference - American Geriatrics Society

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Physical Exam-contd Lungs; Clear to auscultation Heart: S1, S2, regular/regular no murmur Abdomen; mildly distended, normoactive bowel sounds; has PEG tube in left upper abdomen, presence of suprapubic catheter in lower abdomen Extremities; Trace bilateral leg edema; distal pulses symmetric 1+
Physical Exam (cont.) + Cogwheel rigidity in bilateral upper extremities. No resting tremor was noted Neuro/Psych exam: Affect is blunted. Unable to judge attention and concentration, calculation or memory appropriately due to patient status. He does follow commands during exam, however, though very slowly. Language and Speech are impaired with a paucity of verbal response and hypophonic speech. There is no facial asymmetry 17
Page 1 and 2: FELLOW’S MOST DIFFICULT CASE AGS
Page 3 and 4: Chief Complaint/ HPI Urinary tract
Page 5 and 6: HPI (cont.) Patient was fully func
Page 7 and 8: Past Medical History Bipolar disor
Page 9 and 10: Family and Social History: Patient
Page 11 and 12: Medications: 1. Carbidopa-levodopa
Page 13 and 14: Medications (cont.) 25. Gentamycin
Page 15: Physical Exam Vital signs: BP: 117
Page 19 and 20: Functional Status Functional statu
Page 21 and 22: 2012 January: ED visit Urinary ret
Page 23 and 24: 2012 August: Hypotensive, septic s
Page 25 and 26: 2012 September/Oct: Admitted from
Page 27: 27 Thank You!

Most Difficult Case Conference - American Geriatrics Society

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