This ultrasound performed by R3 Family Medicine Resident Dr. DM of HSN demonstrates SEVERE hydronephrosis. This patient came through clinic and had minimal to no pain suggesting this was likely a chronic process. When estimating the degree of hydronephrosis, a general estimate based on the appearance of the renal pelvis is sufficient – there is no such thing as “40% hydronephrosis” or other exact numbers. A patient can have “mild” or “moderate” or “mild to moderate” or in the case of our patient, “severe” hydronephrosis.
A woman presents to Mirebalais with shortness of breath and generalized weakness. On presentation, patient is dyspneic with bilateral crackles and lower extremity edema.
I have also attached a short video of her monitored rhythm.
72 year old female presents to HUM with shortness of breath and increasing lower extremity edema over the last month.
Vitals: SBP 160s, HR 170s, RR 26, O2 sat 94 % on RA
On exam, patient tachypneic, able to speak in short sentences, had irregular heart rate, crackles through lungs with decreased breath sounds bilaterally, distended abdomen with marked bilateral lower extremity edema.
WHAT DOES HER EKG SHOW? (Below is a short video of her monitored rhythm.)
64 year of woman presents to HUM after an episode of dizziness which caused her to fall. No LOC consciousness, no traumatic injury from the fall. Patient without symptoms in the ED.
Vitals: SBP 140, HR 27, RR 14, O2 Sat 99% on room air. Exam unremarkable, appears well for age. Physical exam only demonstrates bradycardia.