Wednesday, August 03, 2005

A "capped" call day

Another day admitting patients...since there are two interns on my team, there's a limit of 10 patients (five per intern) that can be admitted per call cycle. We reached that limit, or cap, at approximately 11:00 PM. My last patient is gone to ultrasound, so I'm killing a little time before she comes back so I can interview her. The attending physician has already seen her, so I've discussed the case with him and pretty much have her admit orders together.

Seems like a good mix of cases today. I've picked up:

  1. Rule-out myocardial infarcation in an elderly Hispanic man.
  2. Heat stroke verses infection in a white female (temp of 109.0), progressing to sepsis, shock, and disseminated intravascular coagulation
  3. Acute arterial insufficiency in a middle-aged white female
  4. Unilateral leg edema in a middle-aged white male
  5. Acute on chronic lower back pain in a middle aged white female with fibromyalgia. Also with acute renal failure, elevated white blood cells, and elevated liver function tests.

It's now 1:30 AM and I've finally finished admitting and getting the patients "tucked in." If I'm fortunate I'll get four or five hours of sleep, and I hope to get few cross-cover calls during the night!!!

3 comments:

Doctor J said...

Number 5 sounds tricky...a fibromyalgia patient with pain. What do you think is at the bottom of her symptoms?

I had an interesting case last weekend...youngish guy with angioedema after taking NSAIDs. No prior history, and no airway compromise (lucky for him). He'll get an outpatient work-up for C1 esterase inhibitor deficiency.

Jonathan said...

Turns out, DoctorJ, that this patient with fibromyalgia has an "organic" cause of her back pain detectible with MRI.

Doctor J said...

What is on the MRI?

Is it responsible for her renal failure, leukocytosis and LFTs?