Professional Documents
Culture Documents
Headache
Doug Kutz MD
75yo male presents to clinic with 10 day history
of a cough, sore throat, fatigue and difficulty
sleeping at night
• Mild dyspnea with exertion
• Bifrontal headache
• No sputum production
• No fevers or chills
• No nightsweats or weight loss
Past Medical History
Coronary Artery Disease; MI and PTCA ‘91
Hypertension
Hypercholesterolemia
Remote history of septic arthritis of the hip
Total hip arthroplasty 1985
Total Knee arthroplasty 1995
Medications
Aspirin 81mg per day
Simvastatin 20mg at hs
Valsartan 80mg per day
Glucosamine
MVI
Social History
Retired civil servant
Married with 3 children
30 pack year history of tobacco through 1983
1 alcoholic beverage per week
No pets at home
Hobbies: fishing and remodeling
Travel to El Salvador for 1 week, 3months earlier, some
diarrhea upon return but no respiratory symptoms
Family History
Brother who died at age 53 of acute MI
Brother with throat cancer in his 60s
Son with Acute Intermittent Porphyria
Visit 1
No distress, vitals unremarkable
Exam normal except for some edema in the
nares and posterior nasal drainage.
Hickham’s Dictum
(patients can have as many diseases as they please)