Age: 81.0
Sex: M
Vaccine: COVID19
Symptoms: Anion gap, Basophil count, Basophil percentage increased, Blood calcium decreased, Blood chloride increased
Clinical narrative: Physician Discharge Summary   Patient ID: MRN: Name:  Age: 82 y.o. Admit Date: 7/7/2022  6:32 PM Discharge Date:  7/10/2022 Unit:  Admitting Physician: MD Discharge Physician: MD   Discharge Diagnosis: Principal Problem:   Blood loss anemia Active Problems:   Mass of left lung   Hemoptysis     Hospital Course:  Admitted with ABL anemia.  GI consulted and performed EGD/colonoscopy with APC to gastric and duodenal angiodysplastic lesions.  PRBCs transfused, 2 units.  Noted to have lung mass.  Possibly a pneumonia so abx were given.  Pulmonary followed patient.  Does not seem that patient and family want further workup for this or CT head findings that were discussed.  Medically stable for discharge home.  F/u with PCP and specialists.  See below for more details.   * Blood loss anemia Stable.  GI following.  S/p EGD/colonoscopy - APC to gastric and duodenal angiodysplastic lesions.  CT a/p pending, had been recommended but not ordered by GI.  Resume ASA.  F/u with GI as outpatient.  PPI PO BID.   Lung mass - abx for pneumonia, Augmentin.  F/u with PCP and pulmonary.   IDA - Niferex BID.  F/u with PCP and GI.   Abnormal head CT - chronic fluid collection a/w midline shift but no evidence of mass effect or herniation.  D/w patient/family.  Declined further evaluation.   Hypothyroidism - continue Synthroid.     CT a/p pending at time of note.  If u/r and Hb remains stable can d/c home.   Consults:   IP CONSULT TO GASTROENTEROLOGY IP CONSULT TO SOCIAL WORK IP CONSULT TO PULMONOLOGY   Significant Diagnostic Studies:    HGB 8.1 Low  g/dL     HCT 25.2 Low  % Basic Metabolic Panel (Abnormal)   Collected: 07/10/22 0059   Updated: 07/10/22 0204   Lab Status: Final result     SODIUM 140 mmol/L   POTASSIUM 4.1 mmol/L   CHLORIDE 107 mmol/L   CO2 22 mmol/L   ANION GAP 11   GLUCOSE 82 mg/dL   BUN 28 mg/dL   CREATININE 1.0 mg/dL   CALCIUM 8.6 mg/dL   OSMOLALITY 284   B/C 28 High    ESTIMATED GFR 71 mL/min    Comment:    *The estimated Glomerular Filtration Rate(EGFR) may not be      accurate for children under the age of 18 yrs.    **To estimate the GFR for African-Americans multiply the      result provided by 1.21.   Stage 1     90 mL/min or greater  Stage 2     60-89 mL/min  Stage 3     30-59 mL/min  Stage 4     15-29 mL/min  Stage 5     14 mL/min or less   CBC (Abnormal)   Collected: 07/10/22 0058   Updated: 07/10/22 0146   Lab Status: Final result     WBC 9.6 10*3/uL   RBC 3.56 Low  10*6/uL   HGB 8.0 Low  g/dL   HCT 23.9 Low  %   MCV 67.3 Low  fL   MCHC 33.4 g/dL   MCH 22.5 Low  pg   RDW 26.7 High  %   MPV 6.5 fL   Platelet Cnt 592 High  10*3/uL   Differential Type Auto   Neutrophils 76.7 High  %   Lymphocytes 12.9 Low  %   Monocytes 7.5 %   Eosinophils 1.8 %   Basophils 1.1 High  %   Neutrophils Abs 7.4 10*3/uL   Lymphocytes Abs 1.2 10*3/uL   Monocytes Abs 0.7 10*3/uL   Eosinophils Abs 0.2 10*3/uL   Basophils Abs 0.1 10*3/uL         Disposition:  home   Discharge Condition:  fair   Discharge Medications and Orders:   Current Discharge Medication List   START taking these medications   Details amoxicillin-pot clavulanate (AUGMENTIN) 875-125 mg per tablet Take 1 Tablet by mouth Twice a day for 7 days. Qty: 14 Tablet, Refills: 0   Associated Diagnoses: Pneumonia due to infectious organism, unspecified laterality, unspecified part of lung   iron polysaccharides (NIFEREX) 150 mg capsule Take 1 Capsule by mouth Twice a day for 30 days. Qty: 60 Capsule, Refills: 0   Associated Diagnoses: Iron deficiency anemia due to chronic blood loss   pantoprazole (PROTONIX) 40 mg DR tablet Take 1 Tablet by mouth Twice a day for 30 days. Qty: 60 Tablet, Refills: 0   Associated Diagnoses: Iron deficiency anemia due to chronic blood loss     CONTINUE these medications which have NOT CHANGED   Details cyclobenzaprine (FLEXERIL) 5 mg tablet Take 1 Tablet by mouth At bedtime. Qty: 90 Tablet, Refills: 3   Associated Diagnoses: RLS (restless legs syndrome)   diltiazem (CARDIZEM CD) 360 mg ER capsule Take 1 Capsule by mouth Once Daily. Qty: 90 Capsule, Refills: 3   Associated Diagnoses: Essential hypertension   levothyroxine (SYNTHROID) 25 mcg tablet Take 1 Tablet by mouth Once Daily. Qty: 90 Tablet, Refills: 3   Associated Diagnoses: Hypothyroidism due to acquired atrophy of thyroid   loratadine (CLARITIN) 10 mg tablet Take 1 Tablet by mouth Once Daily. Qty: 90 Tablet, Refills: 1   Associated Diagnoses: Seasonal allergic rhinitis due to pollen   montelukast (SINGULAIR) 10 mg tablet Take 1 Tablet by mouth Once Daily. Qty: 90 Tablet, Refills: 3   Associated Diagnoses: Seasonal allergic rhinitis due to pollen   Quinapril-Hydrochlorothiazide (ACCURETIC) 20-12.5 mg per tablet Take 1 Tablet by mouth Once Daily. Qty: 90 Tablet, Refills: 3   Associated Diagnoses: Essential hypertension   ibuprofen (MOTRIN) 200 mg tablet Take 1 Tablet by mouth Three times a day as needed for Pain. Qty: 270 Tablet, Refills: 1   Associated Diagnoses: RLS (restless legs syndrome)   aspirin (ASPIRIN) 81 mg DR tablet Take 81 mg by mouth Daily.     STOP taking these medications     predniSONE (DELTASONE) 20 mg tablet Comments:  Reason for St