1. Present Illness

Present Illness

A 37 y.o. white male was admitted with left upper quadrant pain of 2 weeks duration, diarrhea for 3 days, low grade fever, weight loss, malaise, chills, dizziness on standing, poor p.o. intake, and odynophagia to both liquids and solids of 1 month duration.

PMH:
IDDM diagnosed at age of 13 years Right Arrow ESRD
Cadaveric renal transplant in 7 years PTA
2d cadaveric renal transplant in 3 years PTA
Pancreatic transplant 3 years PTA, rejected almost immediately
MI in 7 years PTA
Peptic ulcer disease
2ary hyperparathyroidism Right Arrow parathyroidectomy in 4 years PTA
Peripheral vascular disease Right Arrow multiple AV grafts, left small toe amputation Tenchhoff catheter placement, then removed L femoral posterior-tibial bypass grafting (3 years PTA)
Pericarditis Right Arrow pericardiectomy in 4 years PTA
Most recently, treated for osteomyelitis with IV antibiotics, noted oral thrush last several weeks
Medications:
FK506 3mg bid
Cellcept 1g bid
Insulin NPH 70IU/Regular 10 IU a.m., 10 IU/10IU p.m.
Pepsid 20 mg po qd
Bactrim ss 1po qd
Ca (CO3)2 500mg po tid
Rocalcithol 25 mg qd
Propulcid pm bid
Prednisone 5 mg po qd