71 year old man with hx of a rash.

71 year old man with hx of a rash.

He dates it to a couple of weeks ago when he bought a new pillow. he is concerned about an allergic reacion to the new pillow. A photograph is taken

http://medicinaparaestudiantes.blogspot.es/1314136680/71-anos-de-edad-el-hombre-con-hx-de-una-erupcion/

Middle age man with itching in feet

Middle age man with itching in feet
A 57 year old man with history of metabolic syndrome presents with itchy rash in his feet. It seemed to have begun a couple of weeks prior. He had been seen in the clinic about 2-3 weeks ago with an acute respiratory illness that we treated with a cephalosporin and inhaled steroids. He is not known to suffer from psoriasis or skin disorders. A photograph is taken of a representative lesion in the left foot. What is your diagnosis?

Elderly man with altered mental status

A 79 yar old man with history of chronic hepatitis B and C presents with confusion to the emergency department. His physical exam is no changed or focal. Soon after being amditted he has a generalized seizure. His labs-before the seizure- included Na 136, K 4.6, Cl 105, Bicarb 30, glc 108, BUN 30, creat 0.8. WBC 2,200 per cubic mm, Hgb 106, Plat 32,000 per cubic mm.Ammonia 54Calcium 8.9, Alb 2.1, Mag 1.6A CT of the brain, plain is negative for bleed, infarction, tumor or change.
What is your differential diagnosis and immediate plans?

Should this patient be on a statin and why?

A 62 year old woman presented for follow up. She has a history of diabetes mellitus type 2, well controlled with a HgbA1c at 5.8%. Her family history is notable for her father and a brother who died of acute myocardial infarction before age 60. She has no chest pain or shortness of breath.
Her general physical exam is suggestive of a metabolic syndrome appearance. Her BMI is 31.2 kg/ meter squared.
Her lipid levels are as follows:
Total cholesterol 176 mg/dl
HDL Chol. 49 mg/dl
Triglycerides 71 mg/dl
LDL Chol 113 mg/dl

http://medicinaparaestudiantes.blogspot.es/1299800993/ (En el caso de este paciente, debería ella estar en una estatina y por qué?)

Recurrent Pneumocystis Pneumonia

A 46 year old man wiht HIV infection known since 1995 presents to the hospital with increasing shortness of breath and cough. He was discharged form another community hospital about 3 weeks prior after being treated there for repsiratory failure and PCP pneumonia (P.jarovecki clinical dx.) He is on Atripla, prednisone, Bactrim orally, and supplemental oxygen. On exam he looks ill, somewhat dusky in color. His pulse ox on room air is 88%. His chest exam reveals coarse rales in both bases more pronounced in the right than the left. The heart rate at rest is 122 per minute and regular. The CXR confirms an interstitial bilateral infiltrate and hyperexpansion. The heart silhouette is normal. What course of action should be taken?