60 y.o. M w/ PMH newly diag myelofibrosis. Thoughts? | Figure 1

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60 y.o. M w/ PMH newly diag myelofibrosis. Thoughts?

60 y.o. M w/ PMH newly diag myelofibrosis. Thoughts?

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Case Details

  1. Follow up of the patient with Central Retinal Vein Occlusion. He was taken directly to hospital where my diagnosis was confirmed. And a blood pressure of 270 over 160 was found. Was kept in intensive care for 3 days. and observation a few days more. If he hadn't come for a routine eye exam, he would probably suffer from a massive stroke within a day or two. Out in rural Norway far from the hospital. Secondary diagnosis of glaucoma was also confirmed. And he will get a new check with an ophthalmologist in about one month. When BP is under control and stable.

  2. Resolving hyphema - day 2 - currently being treated with topical steroids and cycloplegic as well as rest, head of bed elevated at night and eye shield. IOP stable though slightly higher in affected eye (OD 13 OS 18)

  3. Female patient in early 70s, complains of sudden appearance of a ‘blood shot’. Known to be hypertensive, but BP is within range. No systemic concerns identified and vital signs are within limits. The patient is not anticoagulated and not taking antiplatelets. Visual assessment is normal. How would you address her concern? How likely is this condition to recur?

  4. 57 y/o male was in court sitting in a chair when he suddenly went rigid and his eyes rolled back into his head. Witnesses state it resembles a seizure. Patient is very diaphoretic. Initial heart rate is lower than what is seen here. EMS unable to obtain a blood pressure on scene; patient appears lethargic. Patient is quickly moved to ambulance, IV placed, 12-lead done.

  5. A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

  6. A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

  7. A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

  8. Patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family. Are there any features in this EKG that would warrant further work-up or is this just a pediatric EKG?