Case Study for Class Discussion:History of Present Illness J.A. is an 83-year-old male who presents to his PCP complaining of a strange rhythmic, throbbing sensation in the middle of his abdomen. He has sensed this feeling for the past three days. For the past several weeks he has also experienced deep pain in his lower back that feels like it is boring into my spine. He describes the pain as persistent but may be relieved by changing position. I think that I hurt my back lifting some firewood, he explains. The patient has never smoked.Past Medical History Triple coronary artery bypass surgery at age 73History of cluster headacheHistory of PUDHistory of OA History of psoriasisRecent history of hypercholesterolemiaMedicationsCelecoxib 200 mg po QD Aspirin 81 mg po QDClopidogrel 75 mg po QDSimvastatin 20 mg po HSMultivitamin tablet QDPhysical Examination and Laboratory TestsAuscultation of the abdomen revealed a significant bruit over the aorta. Palpation of the abdomen revealed an abnormally wide pulsation of the abdominal aorta with some tenderness. When questioned, the patient denied nausea, vomiting, urinary problems, loss of appetite, heart failure, drug allergies, and a history of family members who had been diagnosed with an aortic aneurysm.The patients vital signs were as follows: BP 150/95; HR 83; RR 14; T 98.8deg F; WT 158 lbs; HT 59 Discussion Board:
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