BmdTrDz1. Case Reviews. Case 1. A 33-year-old man has A low HDL level. Should you treat him?. Case #1. A 33-year-old male had a fasting lipid profile as a part of his regular screening. Past medical history (PMH) and family medical history (FMH) Negative.
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Lantus (insulin glargine),
Social history (SH)A remote history of heroin and cocaine abuse, former smoker and drinker.
Physical examinationVS 38-126-24-137/81.Chest: clearCVS: tachycardic but regular with no murmurs.Abdomen: Soft, NT, ND, +BS.
Extremities: Severe venous stasis ulcers of the lower extremities, approximately 1/2 way down and almost circumferential.
The ulcers are full thickness and third-degree. There is a good granulation tissue.
Neuro: He is slow to respond to questioning. No focal neurological deficits apart from diminished sensation on (B) LE.
Diabetic patient with (B) infected stasis ulcers. There is only a small bridge of tissue covering the back of the right leg and the front of the left shin.
Left leg stasis ulcer. Note the hypertrophic granulation tissue at the bottom of the ulcer and the small bridge of skin at the front
Right leg stasis ulcer. Note the previous hallux amputation and the grey-blue discoloration at the bottom of the ulcer. This grey-blue to green discoloration may indicate a Pseudomonas infection.