Follow Up Visits

Question 1

56 yo male with DM follow up. 1. What questions to ask? 2. DDx? 3. What to ask when he mentions decreased libido? 4. Test?

Answer 1

1. Compliance with medications, Side effects, Blood sugar readings, Lowest reading, Symptoms?, Last AIC, Eye doc, foot doc, Neuro complaints, dysuria, polyuria, hematuria, abdominal complaints, foot infection, stroke, MI, Alochol, Smoking. 2. Insulin induced hypoglycemia, Peripheral Neuropathy, Diabetic Peripheral Neuropathy, Alcoholic Peripheral Neuropathy, Multiple Myeloma, Diabetic autonomic neuropathy, vascular disease or medication induced erectile dysfunciton. 3. Onset, Morning erections, Problems with wife. 4. Genital Exam, Serum glucose, AIC, UA, mircroalbumin, BUN/Cr, CBC, SPEP, Doppler US- Penis, Nerve Conduction studies.

Question 2

25 yo female presenting to ED after being assualted. 1. What questions to ask? 2. DDx? 3. Test?

Answer 2

1. Onset, Incident location, Did you recognize the assailants, Did you report the incident, Description of the assault, Assault objects, Sexual Assault, Condom Use, Ejaculation, Type of intercourse, Foreign Objects, Last menstrual periods, Contraceptives, Pain/Location, Radiation, Severity, Alleviating/Exascerbating, Bleeding/Bruises, LOC, HA, Vision, Dizzness, N/W/T, CP, SOB, Palpitations, Blood in urine/stool, Vaginal bleeding, Abdominal Pain. 2. Rib Fracture, Pneumothorax, Hemothorax, STDs, Pregnancy 3. Pelvic Exam, Urine hCG, Wet mount, KOH prep, Cervical Culture, XR,- Skeletal Surgery, HIV antibody, VDRL, HBV antigen, CXR, Evidence collection using rape kit.