Abstract
This clinicopathological case presentation from the University of Maryland details the initial assessment and management of a 55-year-old, dialysis-dependent man with fatigue. We present how one of our emergency medicine faculty develops her differential when faced with this complaint. She describes how she arrives at the suspected diagnosis and the test she believes is needed to prove her hypothesis. The final surprising diagnosis is then revealed.
Highlights
This clinicopathological case presentation from the University of Maryland details the initial assessment and management of a 55-year-old, dialysis-dependent man with fatigue
We present how one of our emergency medicine faculty develops her differential when faced with this complaint
NICHOLS) A 55-year-old male presented to the emergency department (ED) from his dialysis center with two days of fatigue and generalized weakness
Summary
NICHOLS) A 55-year-old male presented to the emergency department (ED) from his dialysis center with two days of fatigue and generalized weakness. He reported that he had been outside in the heat frequently and admitted to poor fluid intake. The patient’s past medical history was significant for end stage renal disease (ESRD) due to focal segmental glomerulosclerosis, hypertension, secondary hyperparathyroidism, obstructive sleep apnea, chronic pancreatitis, and gastroesophageal reflux disease He had an arteriovenous fistula placed in his left upper extremity and had a prior left inguinal hernia repair. On initial examination the patient was awake, alert, well-appearing, and appeared in no acute distress He was afebrile (36.7o Celcius) with a heart rate of 142 beats per minute (bpm) and a blood pressure of 103/69 millimeters of mercury (mm Hg).
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
