Mr B is a 72 year old man with type 2 Diabetes, COPD & stage 3 CKD. On multiple medicines including repeat prescriptions for an ACE Inhibitor and Ibuprofen (NSAID). Mr B experienced an episode of gastroenteritis – without a GP assessment this led to an unplanned hospital admission. The episode of illness was complicated by acute kidney injury requiring a period of intensive care. The hospital…
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Miss R, a 72 year old woman, was admitted for an elective total abdominal hysterectomy. She has a past medical history of hypertension and CKD. Miss R’s GP had already referred her to the renal team related to her CKD, but she had not seen a renal physician prior to her elective surgery. Her baseline serum creatinine preoperatively was 163umol/L, with a eGFR of 26. Post-operatively,…
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Mr T is 85 year old who lives in a nursing home. He has a past medical history of stroke leading to dysphasia and dysphagia and is therefore PEG fed and has a long term indwelling urinary catheter. He is at high risk of infections due to confusion and subsequent trauma to catheter. He is not considered suitable for supra pubic by urology. Medication: clopidogrel 75mg daily,…
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Mr J is a 78 year old man who lives in sheltered housing with his wife Medical history: Chronic heart failure due to LV systolic dysfunction / Previous myocardial infarction / AF / Alzheimers dementia / Hypertension / Osteoarthritis / Previous DHS for fractured neck of femur / Benign prostatic hypertrophy Current medications: Digoxin 125 mcg / Ramipril 2.5mg / Furosemide 40mg / Donepezil / Calcium and vitamin D / Alendronate weekly /…
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The impact of D&V and changes in medicine Mr D is a 60 year old man who was admitted via ambulance from a cricket game where he had been watching a match. The weather had been unusually hot. His friends had been concerned about him throughout the afternoon as he seemed confused, shaky and unsteady on his feet. An ambulance was called after he collapsed. A…
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