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prep [2024/12/12 20:58] – [16:00] adminprep [2025/01/11 22:18] (current) – created admin
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-# bva, d12 +  * **S4200** 
- +    * <todo>mepo filled?</todo>
- +
-# 13:30 +
- +
-lcv: 9/12/24 +
- +
-59F w niCM, chronic HRF likely 2/2 niCM and PH group 2 sp CRT-D (EF 10/15% to 20/25%), moderate persistent asthma on Wixela +
- +
-plan was INCREASE Wixela to high dose, basic ILD workup +
- +
-interval: did not get ILD labs. saw Cardiology; stable CHF sx. likely needs PCSK9i. +
- +
-- <todo>pred dose pack</todo> +
- +
-# 14:00 +
- +
-lcv: 9/12/24 +
- +
-67F w sev COPD on max medical therapy (Breztri, dupi, azithro). comes to VA for meds. wanted pulm rehab referral and to transfer care to VA for sleep med. +
- +
-interval: no pulm rehab, given changes. +
- +
-- AECOPD tx +
- +
- +
-# 14:30 +
- +
-lcv: 9/12/24 +
- +
-74M w GOLD 3B COPD. improved sx on Wixela + Spirva, aTUD (41py). discussed NRT and tob cessation.  +
- +
-interval: seen by tob ces. started chantix and nicotine +
- +
-- same inhalers +
-- cont w NRT, tob ces +
-- fu in 6 months +
- +
-# 15:00 +
- +
-lcv: 8/29/24 +
- +
-79M w CKD G3A iso RCC sp R nephrect, OSA on NIPPV, skin bx in 1960s w sarcoidosis. seen to establish care for ?sarcoid. stage IV (?) pulm sarc w suspected cardiac involvement (CHB sp Mddtronic DTPA2D4 Cobalt XT HF CRT-D) +
- +
-plan was ILD wu, bmp, lft, vit D, no IMTs. defer IMT to Cards given h/o CHB sp PPM (Medtronic biv) +
- +
-ILD labs, PERFORMED +
-RNP: <1.0 (10/30/24) +
-SCL-70: <1.0 (10/30/24) +
-aldolase: 5.9 (10/30/24) +
-CK: 187, ULN 374 (10/30/24) +
-CCP: <16 (10/30/24) +
-ANA: negative (09/03/24) +
-SSA: <1.0 (09/03/24) +
-SSB: <1.0 (09/03/24) +
- +
-HIV: non reactive (10/30/24) +
-HCV: non reactive (10/30/24) +
-quantGOLD: negative (10/30/24) +
- +
-ILD labs, NOT PERFORMED +
-JO-1 +
-myositis pane +
- +
-- sx good +
-- no IMT +
-- fu in 12 months +
-- TBW cards re: card sarc +
- +
- +
- +
- +
-# 15:30 +
- +
-lcv: 9/12/24 +
- +
-74M w GOLD 3E COPD w sev eos (500 to 1,000). plan for action pack, dupi vs benra start, pulm rehab, no pred. +
- +
-interval: 10/22/24 infusion clinic unable to contact. +
-## plan +
- +
-- provide infusion clinic line +
-- START azithro +
-- redo benra start attempt +
- +
prep.1734037134.txt.gz · Last modified: by admin

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