ArogyaUDHC Health Issue ID : 320

( Botanical ) Name of the patient:   Abelmoschus372Esculentus

Solution dated :   Sun, Jun 16, '13

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Health issue inputs URL :   http://www.udhc.co.in/INPUT/displayIssueGraphically.jsp?topic_id=320

Health Issue solution URL :   http://www.udhc.co.in/SOLUTION/viewSolution.jsp?topic_id=320&solution_id=77
The outputs for this patient are numbered serially after each input and the input is displayed here before each output as the ouputs have a direct relation to each input:

Input 1 a) Neuroendocrine tumor (?Primary)

--metastases to lungs and now brain

--being treated with Sorafenib twice a day. 

HP team rep Output 1a: Will continue this for now and defer further management to Dr. **NAME[ZZZ].

Input 1b) Brain Lesion :

--seen by Brain MRI **DATE[Dec 2];

HP team rep Output 1b--Rad Onc consulted; will see as outpatient on Monday to discuss brain radiation options

Input 1c) Acute on Chronic Kidney failure

--has a single kidney s/p nephrectomy **DATE[Dec 2] gunshot wound

--baseline 1.5; >2 on admission, now downtrending

--complicated by mild hyperkalemia

--K and Cr improved with IVF

Input 1c) Hypertension with volume depletion and bradycardia

Ouput 1c)--Holding his home furosemide d/t volume depletion.  Holding propranolol d/t bradycardia while here.  Restarted his home clonidine .2mg TID at discharge, as he was progressively hypertensive since starting steroids

Input 1d) Liver Transplant:  

--immunosuppressive regimen: tacrolimus 1 mg bid

Output 1d)--tacro level 3 on admission; will continue current dosing and get q12h tacro levels to monitor;  per hepatology, level between 4-5 is sufficient given how far out from transplant the patient is

Input 1e) Insulin-dependent Diabetes Mellitus

Output 1e) --Increased home lantus from 10 to 25U qhs d/t steroids. Explained that he needs to titrate up by 2 U every 3-4 days until AM sugar <120.

- Added aspart 8U TID with meals