Differential Diagnosis for 47F with hx of left ventricular aneurysm, GAD, hx of stroke, HTN, HLD
- Single most likely diagnosis:
- Hypertension exacerbation: The patient has a history of hypertension (HTN) and the current lab results show elevated glucose and BUN/Creatinine ratio, which could be indicative of uncontrolled hypertension.
- Other Likely diagnoses:
- Diabetic nephropathy: The patient's glucose levels are elevated, and the BUN/Creatinine ratio is high, which could suggest diabetic nephropathy, especially given the patient's history of hyperlipidemia (HLD) and hypertension.
- Chronic kidney disease (CKD): The patient's eGFR is within the normal range, but the BUN/Creatinine ratio is elevated, which could indicate CKD.
- Metabolic acidosis: The patient's CO2 levels are low, and the anion gap is low, which could suggest metabolic acidosis, although the chloride levels are high.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Adrenal insufficiency: The patient's potassium levels are low, and the sodium levels are within the normal range, which could suggest adrenal insufficiency, although it is less likely.
- Pheochromocytoma: The patient has a history of hypertension, and the BUN/Creatinine ratio is elevated, which could suggest pheochromocytoma, although it is rare.
- Hyperaldosteronism: The patient's potassium levels are low, and the sodium levels are within the normal range, which could suggest hyperaldosteronism, although it is less likely.
- Rare diagnoses:
- Liddle syndrome: The patient's potassium levels are low, and the sodium levels are within the normal range, which could suggest Liddle syndrome, although it is rare.
- Gordon syndrome: The patient's potassium levels are low, and the sodium levels are within the normal range, which could suggest Gordon syndrome, although it is rare.
- Bartter syndrome: The patient's potassium levels are low, and the sodium levels are within the normal range, which could suggest Bartter syndrome, although it is rare.