DVT presentation

1. 59y old male with PMH of DM last Hba1c 6.2 in July , HTN, pulmonary HTN, OSA on CPAP, CKD (nephrotic syndrome) , CHF, EF: 67% presents with right leg swelling Vitals in ER T: 97.7 BP: 183/88 HR: 88 RR: 16 Sao2: 97% on room air

2. GE: well oriented to time ,place and person ,lying on the bed does not seem to be in acute distress CVS: S1, S2 RRR, No Murmurs, PMI not displaced LUNGS: Air movement equal bilaterally, No wheezes or creptitations, P/A: BS+ before palpation, soft, NT, ND, No rebound tenderness, no OM , CNS: A&OX 3, No focal deficit, gaits normal. EXT: No edema, pulses palpable., right leg: edema 2+ upto the knee, erythema and tender , no changes in left leg

3. Labs: Na: 140 K: 4.6 Cl: 106 Co2: 29.9 BUN: 35 Crea: 2.2 Ca: 8 .4 Total protein: 6.2 Albumin: 2.8 Gfr:30 Anion gap:4 WBC: 8.0 HGB: 15.0 Platelets: 192 MCV: 89.4 RDW: 147 APTT: 24.3 PT: 11.0 INR: 1.06

4. Venous Thromboembolism Management Namrata Dass