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D.B. is a 72 year old African American female who presented to the ED with complaints of headache, altered mental status as evidenced by confusion and lethargy, slurred speech, right sided weakness, and a facial droop. Symptoms were first noted when patient woke up from a nap approximately one hour ago. Patient’s daughter is at bedside. Vital signs on arrival: HR 92 irregular, RR 12, BP 172/91, Temp 99.3, blood glucose 163.
Past Medical History
- Hypertension-diagnosed at 50 years old
- Diabetes Mellitus, Type II-diagnosed at 50 years old
- Hypercholesterolemia- diagnosed at 60 years old
- Chronic A-fib- diagnosed last year
- Obesity
- Depression
- Sleep apnea, non-compliant with CPAP
- Frequent falls
- TIA-approximately 2 months ago
Surgical History
- Total hysterectomy, 58 years old
Pertinent Family History
- Mother, deceased at 75 years old- CVA, heart disease
- Father, deceased at 62 years old- diabetes, heart disease
- Brother- HTN
- Sister, deceased at 68 years old- heart disease
Pertinent Social History
- Smoker, 1-2 packs per day for approximately 50 years
- Sedentary lifestyle
- Poor diet, high in sodium