Episode 95: Human Dx unknown with Sharmin & Mercy residents – Hypernatremia
The Clinical Problem Solvers
The Clinical Problem Solvers
4.7 • 528 Ratings
🗓️ 27 May 2020
⏱️ 46 minutes
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| 0:00.0 | Hey folks, just a quick reminder that this podcast is not meant to be used for medical advice, |
| 0:06.7 | just good old-fashioned education, and all-patient information has been modified to protect our identity. |
| 0:13.6 | Welcome back to clinical problem solvers. I'm Julia Burns. I'm currently a geriatric fellow at Mount Sinai |
| 0:19.6 | Hospital in New York City. And I'm very excited for today's episode. I'm currently a geriatric fellow at Mount China Hospital in New York City, and I'm very |
| 0:21.7 | excited for today's episode. I'm here with Brady. Hi, I'm Brady. I'm a PGY3 in Muskegon, Michigan. |
| 0:30.8 | I'm here with my colleague, Aaron Sable. Hi, everybody. I'm Aaron Sable. I work with Brady in Muskegon, Michigan. |
| 0:40.3 | Charmin, what do we have in store today? |
| 0:42.3 | Well, hi, everyone. I'm so excited to be hanging with Julia, Aaron, and Brady. |
| 0:47.3 | Tonight we feature a human diagnosis case. |
| 0:50.3 | We encourage you to download the app and solve the daily GMR cases. It's such a great |
| 0:55.4 | way to get reps in in a short amount of time. Aaron, Brady, and myself, you're all blinded to |
| 1:00.9 | tonight's case. We will try to solve this case in real time. We encourage you to pause and reflect |
| 1:06.3 | after each aliquo of information as well before you respond, you listen to our responses. |
| 1:12.8 | The case creator is Julia Burns, who we are lucky enough to have here with us. |
| 1:17.9 | And the editor for this case is Dr. Miranda Hoffman. |
| 1:20.9 | So Julia, please take it away. |
| 1:23.1 | All right. |
| 1:24.0 | So today we have a 61-year-old female nursing home resident who presents to the emergency |
| 1:30.4 | department after routine labs showed a significantly elevated sodium level of 159. She has been bed-bound |
| 1:38.6 | with a chronic tracheostomy, peg tube, and foley catheter since a complex motor vehicle accident 10 years ago. As a result of the accident, she sustained a traumatic brain injury. She is able to speak with digital occlusion of her tracheosomy, but is unable to follow commands or respond appropriately to questions. She is unable to provide a history. Her nurse from the nursing home |
| 2:03.1 | reports she has been in her usual state of health. No fever, night sweats or weight changes. No vomiting, |
| 2:10.3 | diarrhea, or constipation. No change from her baseline mental status. no increased agitation or delirium. |
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