Reference no: EM133867180
Question
Linda Sanders is a 63-year-old female who presents to you for a refill on her Aldomet, which she has been taking for the past 20 years. She has previously seen her GP who died 1 month ago. She is anxious on this visit, as she has only, on occasion, been examined by her GP before. He usually just took her B/P in the chair and refilled her medications. Other than the HTN, she denies any hospitalizations or other medical problems. ROS- Difficulty sleeping over last month secondary to dyspnea, decreased appetite secondary to nausea, weight gain of 7 pounds over last month. PE 98.9 124/62 HR 118 24 Lungs: few wheezes posteriorly, bibasilar rales. Heart: No JVD, S1, S2, S3 gallop, rhythm regular. Abdomen: Morbidly obese, mild epigastric tenderness with no rebound. Extremities: 2+pitting pretibial edema bilaterally; 2+peripheral pulses; no cyanosis or clubbing, other PE findings WNL.
1. What are the differential diagnoses for this case? Provide top 3 with rationale.
2. What is the most likely diagnosis and why?
3. Which diagnostic test(s) will you order and why?
4. What is your comprehensive management plan for this patient?