Age: 69.0
Sex: F
Vaccine: COVID19
Symptoms: Pathological fracture, Rheumatoid arthritis, Rheumatoid factor positive, SARS-CoV-2 test positive, Troponin increased
Clinical narrative: 70 y.o. Admit date: 7/31/2022 Discharge date and time: 8/3/2022 Attending:     PCP:               Admission  Diagnosis No admission diagnoses are documented for this encounter. Discharge Physician:    Principal Diagnosis COVID     Discharge Diagnosis: Principal Problem:   COVID Active Problems:   Essential hypertension   Rheumatoid arthritis involving multiple sites with positive rheumatoid factor   NSTEMI (non-ST elevated myocardial infarction)       Hospital Course: Patient is a 70-year-old female originally presenting with complaints of weakness.  Onset 3 days prior to admission.  Recent test of covid positive. Found to have elevated troponins.  Admitted for non-ST elevation MI.  Had one significant elevation in troponin but other troponins back around normal for initial troponin.  Suspect lab error.  Seen by cardiology.  Was unable to do stress test due to not being able to lie flat.  Of note posterior Sress test patient was lying flat in bed with no acute issues. Patient will follow-up with cardiology outpatient for reattempt on stress test.  Patient advised if any increase in symptoms to return to hospital for evaluation.  Overall patient says still having weakness but improved.  Asking to go home. Unknown if weakness secondary to Covid.     Relevant ROS:  No fever, no chills weakness, fatigue No chest pain, no palpitations No shortness of breath, no cough No abdominal pain     Physical Exam for 8/3/2022            Blood pressure 122/63, pulse 85, temperature 98.8 °F (37.1 °C), resp. rate 18, height 5' 2" (157.5 cm), weight 54.2 kg (119 lb 7.8 oz), SpO2 93 %. General Appearance: alert, no distress, Weak and ill-appearing Lungs: Diminished right lung base Heart:  regular rate and rhythm Extremities:  No significant edema. Abdomen: no significant distention, soft, nontender Skin: no rash     Consults:   IP CONSULT TO CARDIOLOGY IP CONSULT TO CARDIOLOGY   Significant Diagnostic Studies:    CTA chest Lower extremity ultrasound Transthoracic echocardiogram     Disposition:  home   Discharge Condition:  good   Discharge Medications and Orders:   Current Discharge Medication List     START taking these medications   Details aspirin 81 mg chewable tablet Take 1 Tablet by mouth Once Daily. Qty: 30 Tablet, Refills: 0   Associated Diagnoses: NSTEMI (non-ST elevated myocardial infarction)       CONTINUE these medications which have NOT CHANGED   Details promethazine (PHENERGAN) 25 mg tablet Take 1 Tablet by mouth Every 4 to 6 Hours as needed for Nausea. Qty: 20 Tablet, Refills: 0   Associated Diagnoses: COVID-19   diclofenac (VOLTAREN) 75 mg DR tablet Take 1 Tablet by mouth Twice a day as needed. Qty: 30 Tablet, Refills: 0   Associated Diagnoses: Acute right ankle pain   HYDROcodone-acetaminophen (NORCO) 10-325 mg per tablet Take 1 Tablet by mouth Three times a day as needed for Pain. Qty: 90 Tablet, Refills: 0   Associated Diagnoses: Rheumatoid arthritis involving multiple sites with positive rheumatoid factor; DDD (degenerative disc disease), lumbosacral; Neuritis   gabapentin (NEURONTIN) 400 mg capsule Take 1 Capsule by mouth Three times a day.   alendronate (FOSAMAX) 70 mg tablet Take 1 Tablet by mouth Every Week. Qty: 4 Tablet, Refills: 3   Associated Diagnoses: Osteoporosis, unspecified osteoporosis type, unspecified pathological fracture presence   Ferrous Sulfate (SLOW FE) 142 mg (45 mg iron) TbSR Take 1 Tablet by mouth Daily. Qty: 30 Tablet, Refills: 3   Associated Diagnoses: Iron deficiency   cyanocobalamin 1,000 mcg tablet Take 1 Tablet by mouth Daily. Qty: 30 Tablet, Refills: 3   Associated Diagnoses: B12 deficiency   predniSONE (DELTASONE) 2.5 mg tablet 5 mg.   amLODIPine (NORVASC) 10 mg tablet Take 1 Tablet by mouth At bedtime. Qty: 90 Tablet, Refills: 2   Associated Diagnoses: Essential hypertension   atorvastatin (LIPITOR) 40 mg tablet Take 1 Tablet by mouth At bedtime. CHOLESTEROL Qty: 90 Tablet, Refills: 2   Associated Diagnoses: Hyperlipidemia, unspecified hyperlipidemia type   magnesium chloride (SLOW-MAG) 71.5 mg DR tablet Take 1 Tablet by mouth Daily. Qty: 90 Tablet, Refills: 2   Associated Diagnoses: Medication refill   omeprazole (PRILOSEC) 20 mg DR capsule Take 1 Capsule by mouth Daily. Qty: 90 Capsule, Refills: 2   Associated Diagnoses: Gastroesophageal reflux disease without esophagitis   folic acid (FOLVITE) 1 mg tablet Take 1 Tablet by mouth Daily. Qty: 90 Tablet, Refills: 2   Associated Diagnoses: Rheumatoid arthritis involving multiple sites with positive rheumatoid factor   hydroCHLOROthiazide (HYDRODIURIL) 25 mg tablet Take 1 Tablet by mouth Daily. Qty: 90 Tablet, Refills: 2   Associated Diagnoses: Medication refill   upadacitinib (RINVOQ PO) Take 15 mg by mouth Once Daily.   Cholecalciferol, Vitamin D3, 1,000 unit Cap Take 1,000 Units by mouth Daily.   lidocaine (LIDODERM) 5 %(700 mg/patch) patch 3 Patches by Transdermal route Daily. Qty: 90 Patch, Refills: 3   Associated Diagnoses: DDD (degenerative disc disease), cervical