Nigel Nerdy
55 year old physicist
PC: left lower back pain
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HPC: sudden onset 3 days ago
stabbing pain in left loin, coming in waves
severe attacks lasting about 20-30 min but moderate pain in between
pain radiating down his left groin and left testicle
slightly better when moving about
started to have rigors yesterday x3
had loose stool x2 this morning, constant nausea
no dysuria, didn’t check his temperature
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PMH: renal amyloidosis – not causing problems at present
gout
atrial septal defect, diagnosed in childhood
gynaecomastia - unkown cause
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DHx: allopurinol od
aspirin od
loperamide prn
NKDA
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FHx: mother: Grave’s disease
father: Marfan’s syndrome
grandmother: Alzheimer’s disease
brother: Hodgkin’s lymphoma
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SHx: lives with 3 friends in shared flat
no alcohol, no smoking, vegetarian for 6 months