Case 22: Introduction

Case Published: November 2018

History of Present Illness (HPI)


A 61 year old man with past medical history of alcohol abuse, cervical radiculopathy,  and bilateral knee pain for the 1-2 months presents to your hospital with altered mental status. He is unable to answer questions, but his daughter is able to provide some history:

She notes that she thinks he had developed slowly worsening mental status a few days prior to presentation, per her conversations with him over the phone. She says that he dropped drinking alcohol about a week prior to presentation as he was not feeling well. He used opiates for his knee pain intermittently for the past couple of months, but also had not taken them in about a week. She says that her father lived alone and otherwise did not report any complaints to her. She tells you that he has not smoked or used any illicit drugs.  Routine laboratory studies 3 months ago revealed no abnormalities.

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