A.

Symptoms
1. Why did she have generalized weakness?
2. Why is her temperature 39C 2 weeks ago?
3. Why did she have intermittent fever?
4. Why was the patient anorexic?
5. Why was there generalized weakness after 1 week?
6. Why was there respiratory distress?
7. Why was she wheel chair borne?
8. Why was PE (BP, CR, RR, T)?
9. Why did she have dry lips, skin & buccal mucosa?
10. Why were neck, abdomen, spleen & liver veins checked?
11. Why were heart and lungs checked?
12. Why did BP increased (120108) and CR decreased after 2L PNSS hydration?
13. Interpret blood tests (Hgb, Hct, WBCs).
14. Why was urine checked?
15. Why was plasma Na, K, and Crea checked?
16. Why did BP after admission to ICU?
17. Why was there no change in BP after PNSS infusion?
B. Diabetes
1. Why did blood sugar decrease (100-170mg/dl60mg/dl) 2 days before ER?
2. Why was there slight increase in glucose (CBG=100mg/dl)?
C. Right leg
1. Why was there an erythematous R leg with pain of 6/10?
2. Why was there an unresolved 3x3 ulceration?
3. Why did the swelling persist for a time after scratching the bite?
4. Why did the ulceration increase in size in 2 weeks?
5. Why was there yellowish discharge with accompanying erythema and edema?
6. Why was the erythematous R leg measured now?
7. Why was there tenderness over palpation?
8. Why was wound debrided?
9. Why did she continue antibiotics for 10 days?
D. Drugs
1. MOA: Paracetamol (How did the paracetamol relieve fever?)
2. MOA: Sitaglipin + Metformin, MOA: Perindopril
3. PNSS Infusion
4. MOA: Cefazolin
5. MOA: Norepinephrine & dopamine
6. Why is Norepinephrine > Dopamine?
7. Why did and increase in dopamine caused an increase in BP?
8. Why was 2 mcg/kg/min used as a starting dose?
9. Why was dopamine titrated?
10. Why was the patient off pressors after 3 days?