N340 Case Study #2

Nicole Brassington

Mrs. John has made a full recovery from her recent PNA exacerbation thanks to your care.
Again she has gone on hiatus and has not followed up with you in your office in some
time. She is now 60 years old and has developed morbid obesity which she says is related to
frequent and intermittent doses of steroids taken for SLE flare-ups. She presents to your office
today with moderate shortness of breath and chest discomfort. She also complains of
decreased urine output which has progressively worsened over the past couple months. Lucky
for you she also pulls out an old PFT which she for some reason has stashed in her cigarette
case. It along with her EKG is attached to this case study. You did do a BMP on her and her
Na was 131, K 5.4, Cl 101, HCO3 18, BUN 44, Cr 2.2, Glu 229. You can go from here

Your patients flow volume loop performed by her PCP 2 years ago. She just happened to
have it in her purse in her cigarette case!!!!! Lucky you

Here is her CXR you ordered!