Preventing Unforced Errors - Nuances Of Managing A Complex Collegiate Tennis Athlete

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Preventing Unforced Errors - Nuances Of Managing A Complex Collegiate Tennis Athlete - Page #1

Author: Justin Chan, MD Co Author #1: Kenzie Johnston, MD Senior Editor: Heather Rainey, MD Editor: Yu-Tsun Cheng, MD Patient Presentation: A 22-year-old male collegiate tennis athlete presented to the primary team physician for fall intake physicals as a transfer student in his 5th year. History: He reported commonly feeling tired and nauseous. He denied leg swelling but has noticed that edema develops in his shins during long flights. He reported urinating once nightly and having chronic left lower back tenderness. He mentioned a previous diagnosis of a "kidney disease" but is unsure of the name. He recalled being on a "steroid" previously, though he was unclear about the dose or name of the medication. He also endorsed a history of anemia and gout but denied recent gout flares, shortness of breath, orthopnea, or dysuria. He also denied any history of hearing loss, vision issues, or family history of genetic disorders. Physical Exam: Vitals were significant for temperature of 98.7 F, heart rate of 43 beats per minute. Body mass index was 21.91 kg/m2. The patient was in no acute distress and was well nourished. Head, eyes, ears, nose and throat exam was normal and showed no lymphadenopathy. Cardiovascular exam showed regular rate and rhythm, no murmurs, rubs, or gallops. Respiratory exam demonstrated lungs clear to auscultation bilaterally with a normal work of breathing. The abdomen was soft, nontender, and had normal bowel sounds. Skin exam showed no impressive skin lesions. Extremities showed full range of motion, no edema, joint tenderness, or joint swelling. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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