Somewhere along the line I missed answering:
Cardiac exam demonstrates RRR, S1/S2 w/o murmurs, gallops, or rubs. PMI @ 5th ICS MCL. No splinter hemorrhages either, but great thinking on all of the above.
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Originally Posted by Peregrino
Now we're getting somewhere!  (Sorry, couldn't resist; even a former Bravo knows how much sympathy to expect when you tell the medic you FTFSI.) |
Indeed!
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Originally Posted by Brush Okie
What is he taking the lisinopril for? High BP or kidney problems?
I looked it up and found it can cause hyperkalemia. Sooo I am looking at possibly kidney issue ie kidney problems and or hyperkalemia. Any pedal edema? DC the lisinopril. He did have some darker urine correct? Possable systemic infection due to not following through with dental med working with BP med?
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PT has previously noted history of HTN.
No peripheral edema noted on exam.
The urine was described as mid-yellow with no heme on dipstick and I will add no proteinurea either.
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Originally Posted by Sdiver
Two quick questions ...
1) how long has he been taking his Lisinopril, and most importantly the Atovaquone/Proguanil ?
2) What is his race/ethnicity ?
ETA some differential Dx's .....
Dad's back pain came from jump into Holland so we can r/o that being a genetic trait.
Mom's RA is a possible genetic trait. Which in combination with the Lisinopril could exacerbate the back pain which is a possible side effect of Lisinopril.
The back pain can also be a hypersensitivity to the Malarone (would really like to know his race/ethnicity .... I reference the M*A*S*H episode with Klinger and Goldman taking the Primaquine.) Also Black's having an acute hypersensitivity to Malaria drugs.
Also, the combination of the Mararone and the supplements he's taking may be causing an adverse reaction. The effects of some drugs can change if you take other drugs or herbal products at the same time. This can increase your risk for serious side effects or may cause your medications not to work correctly.
Also possible, a combination of all three above.
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Medication dates already noted a few posts ago.
He's Caucasian.
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Originally Posted by MR2
An echo of his heart would be nice. Can we get a EKG to compare against a baseline?
Lab work - Lites/UA w diff (specifically creatinine level)?
How much ibuprofen/naproxen has he been taking?
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You already have the diff... I think chemistries stretch what one might reasonably be expected to have given the scenario.
He has not yet taken any NSAIDs.