Cough And Reflux Case Study

S- 3671 dispatched to a m pt C/O of abdominal pain and black stool. Pt is a 49 y/o m whose C/C is abdominal and lower back pain. Pt also states that he is experiencing cramping around his left ribcage. Pt states that he has been experiencing N/V/D for the past four days. Pt also states that his bm's have produced black, watery stool since the monday prior to the incident date. Pt is able to provide EMS personnel with a detailed medical Hx that includes HIV, acid reflux, and recently diagnosed COPD. Pt also states that he recently stopped smoking cigarettes. Pt is also able to provide EMS personnel with a list of medications that he is currently taking that includes Duloxetine, Stribild, Ranitidine, Aripiprazole, oxycodone, and proair. Pt states that he has not taken any of his prescribed medications for the past four days prior to the incident date. Pt states that he has allergies to Kaletra and gabapentin. Pt states that his primary

According to the provider, the claimant's cough has been improved. His review of systems was positive for fatigue, malaise, sleep difficulty, shortness of breath, wheezes, and a cough. His blood pressure was 115/71 mmHg and his BMI was 30.35 kg/m2. The physical examination revealed wheezes. Clonazepam was prescribed for agitation. Atorvastatin, Nystatin, Citalopram, and a probiotic were prescribed. Continued use of Aspirin and a regular inhaler were suggested. Further, a follow-up visit with Endocrinology, Cardiology, and Pulmonology. As it relates to a spot in his lung, a repeat CT scan was recommended. The bronchial washes were negative for

HPI: Margaret Elliot is a 52-year-old Caucasian female that is presenting with shortness of breath that has recently worsen. Mrs. Elliot states that her problems began 20 years ago when she had bronchitis, which she consistently has 2-3 times a year. She said that her symptoms have been getting worse the last 2.5 month, but have severely worsen over the past three days. She states that it has been restricting her daily activities and has been troubling her while sleeping lying down. She states that her symptoms improve alittle when she takes her medications. She also states that her symptoms worsen when she tries to walk across the room

Marcy is a 34-year-old female here today with her daughter for a followup regarding her chest pain and GERD. The patient tells me following her last evaluation on July 1st, she did take the Nexium as was recommended. She was taking 40 mg for about a month. She said that worked very well. Her symptoms lessened and ultimately resolved. However, when she ran out of the Nexium, the symptoms are back again. She feels a pain in the lower sternum area, as well as in the upper epigastric area and was relieved when it went away with the Nexium. She has not continued to take it and wonders what she should do next. She is eating and drinking normally. She did try to cut back on dairy as she initially thought that might be related, but found that was not the case and now has that back in her diet. She is up three pounds since I last saw her and is at her highest weight that I have in the office. She is having no nausea, no vomiting. No early satiety. There is no diarrhea. No constipation. No blood in the stool. No melena. She wonders what the next step should be. She does tell me that when she was talking with her family, her mother has had an ulcer and her sister has been diagnosed with "stress ulcers" in the past.

This letter is in response to you inquiry as to whether Farxiga can cause cough. The reference I used to conduct my search included Farxiga’s prescribing information (Astra Zeneca, revised December 2015; available at: dailymed.mlm.nih.gov), Lexicomp (accessed February 5, 2016), Micromedex Solutions (accessed February 5, 2016), Pharmacist’s Letter (accessed February 5, 2016), MEDLINE (1946-February 2016), and an Internet search using Google Scholar as a search engine (accessed February 5, 2016). My search included combination of the following terms: “Farxiga”, “cough”.

Eva is an 8-year-old female here today with her father and her sister with complaints of a cough

D.D has no known allergies and his current vital signs are 36.8F, 115 pulse, 25 RR, 102/77, 91% SpO2. His lab work is all normal except for elevated WBC and glucose. D.D is put on a morphine PCA pump (1.78mg every 2 hours) to help regulate his pain, metronidazole (1500mg once a day) and cefTRIAXone in dextrose (2000mg once a day) to help fight the infection, oxyCODONE (3.6mg every four

O): BLS assessment reveals a 35 y/o/f Pt sitting in a w/c. AOx4/GCS:15. Pupils PEARRL, HEENT clear, -JVD/TD, -CP/SOB, BBS not evaluated, Respiratory rate 16 breaths per minute, SPO2 100% on room air, BP 150/100, HR 96 beats per minute, Skin w/d. Moves extremities sluggishly. Pt claims to have a history nausea, vomiting, hypertension and received a total gastrectomy approximately 5 years ago. Pt states that she vomited twice before arrival and complains of abdominal pain that only subsides when not moving.

The first step for a focused exam is a thorough history and physical that should include a detailed timeline of a cough, provoking and alleviating events, sick contacts, travel and any other possible sources for a cough (Goolsby & Grubbs, 2014). The extent of the diagnostic and assessments will be determined by how the patient presents with a cough and how disruptive the cough is for the patient. Auscultating lung sounds can help find the location, type, and severity of the potential source of a cough (Dains, Baumann & Scheibel, 2016). Examining the head, neck and check externally looking for changes in skin tone/color, jugular vein distention, lymph node status, rashes, hair changes, swallowing, symmetry, retraction of the chest wall,

M. is a 62-year-old female who is a full code, with no known allergies, and has a history of diabetes mellitus. She is five feet, six inches tall and weighs 180 pounds. She reported to her doctor?s office because she has been experiencing chest pain when working in her garden, difficulty breathing, fatigue, and has had unexplained weight gain over the past several weeks. K. M. claims that she never feels well rested no matter how much she sleeps. Also, she has noticed that she has to work very hard to just breathe as she goes about her day.

Vicky has returned for review six weeks since the last appointment. Overall she has been quite well during that time, but having paid closer attention, is reporting intermittent episodes of laryngospasm/vocal cord dysfunction. Specifically after extended periods of talking, Vicky is noticing some tightness in her larynx and at times dysphonia. She may also become slightly breathless, but with slow breathing and resting her voice, her symptoms settle within a few minutes. Separate to this, she has also noted intermittent retrosternal tightness and mild dyspnoea that is consistently relieved with belching. She is no reporting any exertional symptoms.

Yes I would order a chest x ray due to the duration of her cough, the fact that it is post infectious, her age, and to evaluate for pneumonia and masses. Due to the duration of the cough and the fact that her cough is becoming productive with yellow sputum, I would tell the patient she probably started out with a viral bronchitis that now could be transitioning into a bacterial bronchitis and/or Pertussis and I would prescribe an antibiotic that will cover both: Azithromycin 500mg PO day 1, then 250mg PO Daily X 4 days. I would instruct her to buy over the counter mucinex take as directed on box, and drink plenty of fluids. If the cough does not improve in 3 weeks have her follow up.

PMH: Charles has history of Intermittent asthma since he was 2 years old, uses Ventolin inhalers as PRN. Mother reports that prior to current illness Charles was having asthma symptoms requiring inhaler use 1-2 times/week, typically during the day, lasting 1-2 hours, without effect on Charles’ activity. Attacks have occurred both at home and outdoors. Charles is a full term baby, product of NSVD, with no antenatal complications. Birth weight was 3000g, with apgar score of 9 in both 1 and 5 minutes. History of adenoid hypertrophy diagnosed at the age of 2 years. Patient is followed up by ENT. History of recurrent URTI, the last visit to ER was last month due to fever, coughing, and runny nose, treated as viral infection. History of otitis media 3 months ago that was treated with Azithromax. Up to date with vaccinations, the last Flu shot given on April 2,

Surprisingly given the fact that he cough has improved and that she has no other significant symptoms, there has been worsening changes with some new changes in the left lower lobe. The significance of this is uncertain given her good symptomatic state and her clear examination with her saturating at 98% on room air and clear lung fields today. We have discussed possible proceeding to a bronchoscopy versus an expectant approach of repeat imaging in three months’ time. Virginia is keen for the expectant approach and I think that that is very reasonable. As such, I will see her in about three months’ time with some repeat lung function tests, but I have asked her to call me earlier if she has worsening respiratory symptoms, at which stage we would consider organising a

He admits to a 25 pound weight gain over the last few months. The patient was