Case Presentation, Part I
a. Chief Complaint and Medical History
Mrs. Nguyen, a 61 year-old long-time diabetic patient of yours, presents to your office with a chief complaint of abdominal pain. You met her 20 years ago when she first arrived from Vietnam. Since then, she returns to Vietnam every year to visit her family. She has just returned from her latest trip and comes to visit you because of abdominal pain, fatigue, and easy bruising.
Her abdominal pain started 4 months ago and is always present. She has had nausea and vomiting for the last few days. She says, "My eyes are yellow now, I am so tired all the time, and I am covered in bruises."
She brings with her a bag of herbal products and wants to know if you think the products that she has been taking are the cause of her problems.
Past Medical History
Hypertension
Hyperlipidemia
Diabetes
Mild osteoarthritis
Gastroesophageal reflux disease
Atrial fibrillation |
Family History
Father: AAA; died in Vietnam
Over the counter Products
Motrin 400mg three times a day, most days
Vietnamese and Chinese herbs
Garlic 3-4 cloves a day |
Medications
HCTZ 25mg after breakfast daily
Metformin 1000mg before breakfast daily
Lipitor 40mg after breakfast daily
Prilosec 20mg before breakfast daily
Warfarin 5mg at bedtime daily |
Social History
Born in Vietnam, came to US 20 years ago
High school teacher
Married, 3 children
No alcohol, drugs, cigarettes |
Please take a moment to reflect and answer the following question in the space provided (approximately 5 min).
List two additional questions you want to ask Mrs. Nguyen at this point:
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