C09989320 / invoice 10000

Appointment Notes: Recheck - wants to discuss zydax injections and a few matters - CL *req JBHistory:Doing much better since pancreatitis flare upLame on RH after falling on last stepExamination: QAR, pale mm (prior splenectomy, benign changes)Thoraicc ausc HR 120, no audible murmurTense abdo palp. Multiple subcut lipomas over abdomenR stifle hypertextends and pain when pressure on medial aspect where TPLO plate would beBoth hips reduced ROMLF elbow issues (historic injury)Purulent discharge from penis and licking+++ Assessment:Recommended urinalysis (ideally cysto) with radiographs of hips/stiflesDiscussed potential joint tap and O reluctant for GA/surgery but OK with sedation - recommended repeat pre-GA bloods as had very high WBC count previouslyOngoing budesonide Plan:Admit tomorrow for xrays and urinalysis - may consider zydax course, O aware may be some further testing like FNAs/joint tap etc    Vital Signs