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Case 14: 65M presents to the ED with complaints of R hand weakness and difficulty speaking which had lasted a few hours, and resolved entirely before arrival in the ED. + smoking with 30 pack-year hx. Takes enalapril, simvastatin, and metformin for HTN, HL, and type2 DM.

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

User Broot
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1 Answer

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Final answer:

A 65-year-old man with symptoms suggesting a transient cerebrovascular event requires a series of emergency orders, including a physical exam and diagnostic tests such as a CT scan. Initial therapy may include aspirin. Further management and final diagnosis would guide the patient's admission to a specialized unit and final orders.

Step-by-step explanation:

Case Presentation and Expected Management

A 65-year-old man with a history of hypertension (HTN), hyperlipidemia (HL), and type 2 diabetes mellitus (T2DM) presents to the emergency department (ED) with transient right hand weakness and speech difficulty, which resolved before arrival. The key components in managing this case include: emergency orders, a physical examination, diagnostic tests, initiating therapy, deciding the appropriate location for care, and finalizing orders based on the diagnosis (Dx).

Emergency Orders and Physical Exam

Upon presentation, the man would require emergency orders that prioritize assessing his immediate neurological function and cardiovascular status, given his risk factors and symptoms suggestive of a cerebrovascular event. The physical exam is likely to consist of cranial nerve testing, muscle strength assessments, and sensory evaluations, including tests for proprioception and light touch discrimination.

Diagnostic Tests

Diagnostic tests such as a CT scan might be indicated to rule out a stroke or transient ischemic attack (TIA). Initial therapy in this setting could involve aspirin to reduce the risk of thromboembolism.

Therapy and Location

Based on the nature of presenting symptoms and the need for ongoing monitoring, the patient might be admitted to a stroke unit for further evaluation and management.

Final Order and Diagnosis

The final order would be based on diagnostic findings, which could point toward a TIA or stroke, with appropriate adjustments to the management plan according to the specific diagnosis.

User Norders
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