The Case Files: Renal Infarct

Dubrovskiy, Aleksandr DO; Levy, David DO; Saadatmand, Babak MD A 56-year-old man with a past medical history significant for hypertension, hyperlipidemia, and sciatica presented to the ED complaining of a sudden onset of sharp, severe, right flank pain radiating to his right groin. The pain began about 30 minutes prior to arrival and had been constant since onset. He denied any alleviating or aggravating factors, trauma, or prior occurrences. He complained of nausea without vomiting, and review of systems was otherwise negative. He had no recent surgeries and denied any alcohol, smoking, or drug use. The patient was allergic to penicillin, and was compliant with his prescribed atorvastatin (Lipitor), aspirin, niacin (Niaspan), olmesartan (Benicar), multivitamin, folate, and fish oil. He was unsure about his family history. His temperature was 98.6°F, pulse was 50 bpm, respiratory rate was 20, blood pressure was 123/79 mm Hg, and oxygen saturation was 100% on room air. His general appearance reflected a well-nourished but uncomfortable man who was unable to sit still secondary to pain. His pupils were equally round and reactive to light with extraocular muscles intact. He had no rhinorrhea, and his pharynx was clear. His neck was supple, nontender, and without lymphadenopathy. He had a regular heart rate with normal S1 and S2 without murmurs, rubs, or gallops. His lung sounds were clear bilaterally without wheezing, rales, or rhonchi. He had significant right costovertebral a...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research