Differential Diagnosis for 73 F with hx of HTN, anxiety, HLD
Single Most Likely Diagnosis
- Chronic Hydrochlorothiazide-induced Hypokalemia and Mild Anemia: The patient's lab results show low sodium (134 mmol/L) and low potassium (4.2 mmol/L) levels, which could be attributed to hydrochlorothiazide use. The mild anemia (Hemoglobin 12.1 g/dL) could be related to chronic disease or medication side effects.
Other Likely Diagnoses
- Viral Infection: The patient's low neutrophil count (26.4%) and high lymphocyte count (63.9%) could indicate a viral infection.
- Medication-induced Leukopenia: The patient's low white blood cell count (4.5 K/mcL) could be a side effect of Zoloft or other medications.
- Chronic Kidney Disease: Although the patient's eGFR is within normal limits (92 mL/min/1.73m2), the high BUN/Creatinine Ratio (20.3) could indicate early kidney disease.
Do Not Miss Diagnoses
- Sepsis: Although the patient's vital signs are not provided, the low neutrophil count and high lymphocyte count could indicate a severe infection. Sepsis is a life-threatening condition that requires prompt diagnosis and treatment.
- Leukemia or Lymphoma: The patient's abnormal white blood cell count and differential could indicate a hematologic malignancy.
- Adrenal Insufficiency: The patient's low sodium and potassium levels could be indicative of adrenal insufficiency, which is a life-threatening condition if left untreated.
Rare Diagnoses
- Felty's Syndrome: The patient's rheumatoid arthritis (not mentioned in the history, but possible) and abnormal white blood cell count could indicate Felty's syndrome, a rare condition characterized by rheumatoid arthritis, splenomegaly, and neutropenia.
- Pernicious Anemia: The patient's mild anemia could be related to pernicious anemia, a rare condition caused by vitamin B12 deficiency.
- Myelodysplastic Syndrome: The patient's abnormal white blood cell count and differential could indicate myelodysplastic syndrome, a rare group of disorders characterized by bone marrow failure.