Patient Details

Metformin XR 2g PO mane

Lantus 30 units S/C nocte

Actrapid 20 units S/C mane, 10 midday, 20 units nocte.

Telmisartan 80mg PO mane

Hydrochlorothiazide 12.5mg PO mane

Atorvastatin 40mg PO nocte

Aspirin 100mg PO mane

Metoprolol 25mg PO BD

Nitrolingual pump 1 spray S/L PRN

Clexane 40mg S/C nocte

Calcium 1200mg PO BD

Targin 20/10mg PO BD

Endone 5-10mg Q4H PRN

Morphine S/C 5mg Q4H PRN

Ondansetron 4-8mg IV/SL Q4H PRN

Metoclopramide 10mg IV/PO Q6H PRN

This patient had a CT which showed acute pancreatitis. He was moved to HDU for closer monitoring and aggressive IVF. The patient’s pain has not subsided; it is progressively getting worse. There is associated vomiting and general deterioration. The electrolytes are becoming deranged. The patient has becoming febrile, tachycardia and hypotensive. There is poor glycaemic control and evidence of an AKI. Urine output had markedly dropped off and the patient is becoming drowsy. You perform a new CT scan which showed infected pancreatic necrosis. 

Appendicectomy

Tonsillectomy

Transurethral resection of the prostate (TURP)

Insulin dependent Type 2 diabetes

Ischaemic heart disease

Hypertension

Dyslipidaemia

NKDA 

Mr Williams’ mother died of breast cancer and his father died of an AMI.    

Mr Williams is a retired mechanic who lives alone in Armidale. His wife died four years ago after a long battle with metastatic breast cancer. He has the support of a daughter (Mary) who lives close and helps with some of the washing, cooking and shopping. He walks independently inside his house but uses a walking stick outside the house for support.

He is a non-smoker and only drinks on occasion.