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Case 42: 30F brought to ED w/ 3 day hx of fever, headaches, and AMS. Also has impaired memory and hallucinations. No PMH, no meds, and no sick contacts. Vitals show low grade fever and are otherwise normal.

1. Emergency orders
2. Physical Exam
3. Diagnostic tests
4. Therapy
5. Location
6. Final order
7. Dx

User AntiCZ
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1 Answer

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Final answer:

The patient in the case presented has a history of fever, headaches, altered mental status (AMS), impaired memory, and hallucinations for 3 days. Based on the symptoms, the emergency orders may include a complete blood count (CBC), blood cultures, a lumbar puncture, and a comprehensive metabolic panel (CMP). The diagnostic tests would include the ones mentioned above, as well as imaging studies like a brain MRI or CT scan to rule out any neurological conditions.

Step-by-step explanation:

The patient in the case presented has a history of fever, headaches, altered mental status (AMS), impaired memory, and hallucinations for 3 days. Based on the symptoms, the emergency orders may include a complete blood count (CBC), blood cultures, a lumbar puncture, and a comprehensive metabolic panel (CMP). These tests would help identify any underlying infection or abnormalities that may be causing the symptoms. The physical exam would involve assessing the patient's vital signs, performing a neurological examination, and checking for any signs of infection or inflammation. The diagnostic tests would include the ones mentioned above, as well as imaging studies like a brain MRI or CT scan to rule out any neurological conditions. Therapy would depend on the final diagnosis, but may include antibiotics for infections, antipyretics for fever, and supportive care to manage symptoms. The patient would be located in the emergency department initially for evaluation and stabilization, and may be admitted to a medical or neurological unit depending on the final diagnosis and treatment plan. The final order would involve prescribing any necessary medications, arranging follow-up appointments, and providing discharge instructions. Based on the symptoms described, a possible diagnosis could be encephalitis, which is inflammation of the brain, often caused by viral infections. This would require further evaluation and confirmatory tests.

User ReFran
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