Received May 20, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| PNC20 | PNEUMO (PREVNAR20) | PFIZER\WYETH | 1 | LN4927 | IM / LA |
acute onset left facial and left upper extremity numbness, peripheral vision loss associated with dizziness and gait imbalance. Per patient above symptoms started around 630 AM. admitted on 05/12/2025 with PMH of HTN, hypothyroidism, asthma, arthritis who presented for acute left facial and arm numbness, vision loss, and dizziness with last known well time at 2230 on 5/11/2025. Neurological examination revealed decreased sensation over left V1-V3 distribution, monocular left eye double vision with left lateral gaze, and NIHSS of 1 for mild-to-moderate sensory loss. CT/CTA head and neck were negative for acute findings with no large vessel occlusion, and MRI Brain and Orbit with and without contrast on 5/12/2025 showed no evidence of acute stroke. The patient was not a thrombolysis candidate as last known well time was beyond 4.5 hours, and was started on ASA 81 mg daily. By 5/13/2025, all neurological symptoms had completely resolved, and TIA was determined to be the most likely diagnosis with secondary stroke prevention measures recommended, including initiation of Crestor 20 mg daily to target LDL <70 mg/dL Patient deferred this for now, advised to discuss with his PCP. Blood pressure was managed with home medications (amlodipine 10 mg daily and lisinopril 40 mg daily) plus PRN IV labetalol/hydralazine with a goal SBP <140 mmHg. The patient's other medical conditions included hypothyroidism (on levothyroxine 125 mcg daily), gout (on allopurinol 450 mg daily), respiratory conditions (asthma, COPD, OSA requiring CPAP), and GERD with esophageal stricture (on pantoprazole 40 mg daily). Incidental findings included sinusitis on MRI, mildly elevated liver enzymes (AST 42 U/L, ALT 38 U/L), and elevated sedimentation rate (13 mm/hr), with a transthoracic echocardiogram with no PFO , no thrombus, no shunts
Class 2 severe obesity, Hypertension, Hyperlipidemia, Hypothyroidism, Obstructive Sleep Apnea, Mild Intermittent Asthma, Seasonal Allergies, Gastroesophageal Reflux, Erectile Dysfunction, Drug Induced Rash, Stress
Class 2 severe obesity, Hypertension, Hyperlipidemia, Hypothyroidism, Obstructive Sleep Apnea, Mild Intermittent Asthma, Seasonal Allergies, Gastroesophageal Reflux, Erectile Dysfunction, Drug Induced Rash
Allopurinol 300 MG, Amlodipine Besylate 10mg, Cetirizine HCL 10 mg, Clobetasol Propionate 0.05%, Fluticasone Propionate 50mcg, Fluticasone/Vilanterol 100-25 mcg, Guaifenesin/Dextromethorpan 30-600 mcg, Hydrocortisone 1%, Ipratropium/Albuter
Hydrochlorothiazide
-LDL 125 HgbA1c 5.5 CT/CTAs non-acute. On exam, visual fields full no peripheral deficit noted, L eye monocular double vision present along with L facial numbness. \ sinus fullness clinically, and confirmed on MRI