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Generalized Weakness

History of Present Illness:

A 62-year-old male with a history of cancer and recent admission presents to the ED for 4 days of generalized weakness and decreased PO intake.   He denies any chest pain, palpitations, vomiting, diarrhea, focal weakness, pain or other complaints

Vital Signs & Physical Exam:

Vital signs are normal except for   Physical exam is otherwise normal except for dry mouth

Initial Differential Diagnosis:

  • Dehydration
  • Syncope
  • PE

Initial Diagnostic Testing:

  • EKG: none
  • Labs: none ordered
  • Imaging: none

QUESTIONS:

  1. What does the case image show?  
  2. What should you do next?  
  3. Want a 1-minute consult/tutorial on this case? 
  4. Want to know what happened with this patient?

SCROLL DOWN FOR ANSWERS & 1-MINUTE CONSULT

 

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ANSWERS:

  1. What does the case image show?  The image shows .
  2. What should you do next?  Treat with.  Consult.
  3. Want a 1-minute consult/tutorial on this case?  See yellow area from sample page below.
  4. Want to know what happened with this patient?  See case conclusion below tutorial page.

1-Minute EM Consult on the topic for this case from the Emergency Medicine 1-minute Consult Pocketbook

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CASE CONCLUSION: We’ll just have to see

CASE LESSONS: Although not infrequently performed, head CT is very low yield and rarely indicated in syncope or near-syncope.  It should be ordered selectively.  This case is a good example of patients not always being very good at noticing what is wrong with their body.

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