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An 80-year-old woman is referred for surgical consultation after a solid renal mass is discovered incidentally while evaluating the cause of chronic abdominal pain. She presents alone without a family member. The patient has a history of hypertension, chronic atrial fibrillation, vitamin D deficiency, osteoporosis, and osteoarthritis. She has no history of previous surgery. Current medications include hydrochlorothiazide (25 mg daily), vitamin D3 (1000 IU daily), diltiazem (30 mg 4 times daily), calcium carbonate (500 mg 2 times daily), warfarin (2.5 mg at bedtime), and acetaminophen (500 mg 2 times daily). She lives alone at home and has an established advance directive. The patient uses a cane for ambulation and reports no falls. A review of systems survey completed on arrival is negative. Her temperature is 37°C (98.6°F), pulse is 90/min and irregular, respirations are 12/min, and blood pressure is 135/85 mm Hg. The patient is alert and oriented. Physical examination is noncontributory. Cardiac and pulmonary systems have been evaluated and were cleared by the primary care physician.
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Release Date: 08/19/2021
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Ruben Azocar, MD
George Drach, MD
Sandhya Lagoo-Deenadayalan, MD, PhD
Andrew Lee, MD
Mike Malone MD
Myron Miller, MD
Arvind Nana, MD
Tom Robinson, MD
Victoria Tang MD, MAS
The following members of the advisory panel have reported relevant financial relationships with ineligible companies that have been mitigated through peer review of planning decisions by persons without relevant financial relationships and recusal from any aspect of planning and content related to the financial relationship:
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Tomas Griebling, MD
Joseph Hejkal, MD
Melissa Hornor, MD
Jason Johanning, MD
Sushila Murthy, MD, MPH
Tony Rosen, MD, MPH
Kate Schenning, MD, MPH
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Shamsuddin Akhtar, MD
Patrick Kortebein, MD
Joseph LoCicero, MD
This CME activity is supported by a grant from the John A. Hartford Foundation.
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