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Acute Inflammation, cataract, glaucoma, and blindness
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RM is a 63 y/o WM with 26 year history of DM which has been insulin-dependant, hypertension, hyperlipidemia, GERD, peripheral vascular disease s/p Fem/Pop bypass, coronary artery disease (s/p MI 2008), who was was admitted with a one month history of severe myalgia, fevers, fatigue, night sweats, anorexia, some nausea and possible diarrhea. On admission he was confused, dehydrated and in mild renal failure.
His was treated with Tamiflu, cyclobenzaprine, Vicodin, Reglan, Coreg, Norvasc, Zocor, clonidine, hydrocholorthiazide, lisinopril,
Prilosec, metformin, insulin, and Trental. He also received systemic antibiotics.
On physical exam his BP was 134/50, pulse 97, temp 98.2, in no acute distress, pleasant but confused, protuberant abdomen, non-acute EKG changes, and BUN of 60.
Several days after admission, his right eye became acute red, mildly proptotic, developed markedly diminished vision and increase IOP of 30, associated with lid edema but minimal pain (although tender to touch).
What is your differential diagnosis and what tests do you want to do?
Tags
acute inflammation, renal failure, peripheral vascular disease, anorexia, blindness, glaucoma, hyperlipidemia, hypertension
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