Age: 77.0
Sex: M
Vaccine: COVID19
Symptoms: Orthostatic hypotension, Peripheral artery aneurysm, Pyrexia, Thrombocytopenia
Clinical narrative: HBS DISCHARGE SUMMARY Date of Admission: 10/20/2023   Date of Discharge: 10/22/2023   Pending Study Results at Discharge:  Unresulted Lab Orders    No orders found from 9/22/2023 to 10/23/2023.       Final Diagnoses:  Active Hospital Problems   Diagnosis   ? COVID-19 DISEASE   ? MAJOR NEUROCOGNITIVE DISORDER DUE TO PARKINSONS DISEASE (PARKINSONS DEMENTIA)   ? ABDOMINAL AORTIC ANEURYSM 3.0-3.4 CM       11/17/20 CT a/p: 3.1cm AAA   PT FOLLOWED BY   Regional Vascular Guidelines for AAA:  Abdominal Aortic Aneurysm Negative; No further follow up : < 2.7 cm US, < 3.0 cm CT 2.7cm ? 3.4cm US: US in 3 yrs 3.0cm ? 3.4cm CT: US in 3 yrs  3.5cm- 3.9cm: US in 1 year >/= 4.0cm: Refer to Vascular Surgery  ALL saccular aneurysms should be referred to VSS regardless of size.     ? RIGHT COMMON ILIAC ARTERY ANEURYSM       11/17/20 CT a/p:  1.5cm bilateral CIAA's   PT FOLLOWED BY   Regional Aneurysm Surveillance and Referral Guidelines Iliac Artery Aneurysm;  < 1.5 cm: Negative; No further follow up 1.5 cm ? 1.7 cm: US in 3 years 1.8 cm ? 2.4 cm: US in one year >= 2.5 cm: Refer to Vascular Surgery All Saccular aneurysms should be referred to VSS regardless of size.      ? LEFT COMMON ILIAC ARTERY ANEURYSM       11/17/20 CT a/p:  1.5cm bilateral CIAA's   ? PARKINSONISM   ? MILD COGNITIVE IMPAIRMENT OF UNKNOWN ETIOLOGY   ? MAJOR DEPRESSIVE DISORDER, RECURRENT EPISODE, IN FULL REMISSION   ? HX OF PROSTATE CANCER   ? ATHEROSCLEROSIS OF AORTA   ? HYPERLIPIDEMIA   ? OBESITY, BMI 32-32.9, ADULT       Estimated Body mass index is 32.58 kg/(m^^2) as calculated from the following:   Height as of 10/2/12: 5' 9"(1.753 m).   Weight as of 10/2/12: 220 lb 9.6 oz(100.064 kg) .     Resolved Hospital Problems   Diagnosis Date Resolved ? ALTERED MENTAL STATUS, UNSPECIFIED 10/22/2023 ? DELIRIUM 10/22/2023     Discharge Disposition:  Addendum: Patient discharged home    Medications, instructions, follow up information: See patient Discharge Instructions/AVS.   Hospital Course and Significant Findings: Patient is a 80 Y  male with a history of hyperlipidemia, parkinsons disease with dementia, depression, abdominal aortic aneurysm, bilateral iliac aneurysm, was bought in from home due to fever and altered mental status 2/2 COVID-19.     SEPSIS 2/2 COVID-19 DISEASE (10/20/2023) Positive at home test with fevers, not hypoxic and chest x-ray normal, therefore defer steroids. Received remdesivir inpatient. De-isolate on 10/30/2023.    ALTERED MENTAL STATUS, UNSPECIFIED (10/20/2023)  DELIRIUM (10/20/2023) Due to COVID-19 and mentation returned to baseline.      ANEMIA   THROMBOCYTOPENIA  Likely 2/2 COVID infection and dilutional, no overt sign of bleeding. Iron studies consistent with anemia of chronic inflammation.   PARKINSONISM (3/10/2014)  MILD COGNITIVE IMPAIRMENT OF UNKNOWN ETIOLOGY (8/31/2021)  MAJOR NEUROCOGNITIVE DISORDER DUE TO PARKINSONS DISEASE (PARKINSONS DEMENTIA) (2/2/2023) Complicated by falls and unsteady gait from parkinsons induced orthostatic hypotension. Continue Sinemet 1 tab AM / 3 at noon / 3 in evening / 2 at bedtime. PT recommending skilled nursing facility however family opted to go home as no isolation beds were available in county.   ABDOMINAL AORTIC ANEURYSM 3.0-3.4 CM (11/25/2020) Continue monitoring    RIGHT COMMON ILIAC ARTERY ANEURYSM (11/25/2020)  LEFT COMMON ILIAC ARTERY ANEURYSM (11/25/2020) Continue monitoring    HYPERLIPIDEMIA (2/21/2006)  ATHEROSCLEROSIS OF AORTA (11/20/2014) Continue lovastatin 40mg daily    HX OF PROSTATE CANCER (2/27/2015) Noted    MAJOR DEPRESSIVE DISORDER, RECURRENT EPISODE, IN FULL REMISSION (9/3/2020) Continue prozac 40mg daily    OBESITY, BMI 32-32.9, ADULT (11/8/2012) Continue outpatient optimization   Primary Procedures:  None   Secondary Procedures: None   Reason for Hospital Admission (Admitting Diagnosis):  COVID-19    Complications: none   Consults:  HOSPITAL MEDICINE - INITIAL INPATIENT CONSULTATION. HOSPITAL MEDICINE - ONGOING INPATIENT CONSULTATION. PALLIATIVE CARE - INITIAL INPATIENT CONSULTATION. PALLIATIVE CARE - ONGOING INPATIENT CONSULTATION. Smoker: No.   Condition on Discharge: stable   Code Status at Time of Discharge: DNR       Note Details  Author (M.D.) File Time 10/23/2023  8:29 AM Author Type Physician Status Addendum Last Editor  (M.D.) Specialty Hospital Medicine Hospital Acct #  Admit Date 10/20/2023  ED to Hosp-Admission (Discharged) on 10/20/2023  ED to Hosp-Admission (Discharged) on 10/20/2023   Revision History   Detailed Report  Note shared with patient Additional Orders and Documentation   Results Imaging   Meds    Orders    Flowsheets   Encounter Info:  History, Allergies, Education, Care Plan, Detailed Report   Hospital Problem List   HYPERLIPIDEMIA  OBESITY, BMI 32-32.9, ADULT  PARKINSONISM  ATHEROSCLEROSIS OF AORTA  MAJOR DEPRESSIVE DISORDER, RECURRENT EPISODE, IN FULL REMISSION  ABDOMINAL AORTIC ANEURYSM 3.0-3.4 CM  RIGHT COMMON ILIAC ARTERY ANEURYSM  LEFT COMMON ILIAC ARTERY ANEURYSM  MILD COGNITIVE IMPAIRMENT OF UNKNOWN ETIOLOGY  MAJOR NEUROCOGNITIVE DISORDER DUE TO PARKINSONS DISEASE (PARKINSONS DEMENTIA)  HX OF PROSTATE CANCER  COVID-19 DISEASE  ALTERED MENTAL STATUS, UNSPECIFIED Resolved  DELIRIUM Resolved Care Timeline  10/20   Admitted from ED (Observation) 1602 10/22   Discharged 1957  Discharge   Home or Self Care.   Discharge Instructions (AVS) (Printed 10/22/2023)