Prepared by Cherie Gan
Mdm Foo is a 77 year old Chinese lady. ADL I Comm ambulant without aid. She has a background of hypertension, hyperlipidemia, DM on diet control, AF, previous rheumatic heart disease with mitral stenosis. She is on Warfarin 2mg OM, simvastatin 20mg ON, nifedipine 30mg OM and bisoprolol 2.5mg OM.
She has been admitted to IM on your call after a fall. She had slipped and fallen in the toilet and landed on her L arm, L leg, and knocked her head lightly against the wall.'
She had no chest pain/ SOB/ palpitations, no giddiness, no weakness or numbness before the fall. No LOC as well. Post fall she was able to get up with some help and complained of mild headache and L arm and L leg pain. On systemic review you discover she has been unwell in the past week with low grade fever and cough, and took some medications that her nephew gave her. Rest of systemic review unremarkable
O/E, she is alert and oriented. Otherwise, neuro exam is normal. H S1 S2 MDM. Lungs clear. Abdomen soft non tender. Bruises noted over L arm and L leg and L temporal region
1) What are the most pertinent/relevant invx to do? Pick 5
c) 2D Echo
f) MRI brain
i) UFEME urine cultures
j) skull xray
k) CT brain
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