Past medical history: Known CAD, hypertension, hyperlipidemia, impaired fasting glucose, osteoarthritis of knees.
Medications: Lisinopril 20 mg orally PO once daily in the evening; hydrochlorothiazide 12.5 mg PO once daily in the morning; metoprolol 50 mg PO once daily in the morning; simvastatin 20 mg PO once daily. OTC medications include Aleve, two tablets every 12 hours when needed for severe knee pain (infrequent use); topical Icy Hot for knee pain daily; glucosamine-chondroitin preparation daily for joint health; multivitamin for male more than 50 years daily.
Vital signs: Blood pressure (BP) 130/84 mm Hg; heart rate (HR) 60 beats per min, regular; respiratory rate 16 breaths/min; temperature 99.2°F orally; BMI 38.
Physical findings are unremarkable.
- What additional subjective data are you seeking?
- What additional objective data will you be assessing?
- What national guidelines are appropriate to consider?
- What tests will you order? How will you decide on prioritizing in this patient with multiple symptoms?
- What are the differential diagnoses that you are considering? For each one, map out your clinical
reasoning for and against it and make a tentative plan to confirm it or rule it out.
- Will you be looking for a consultation?