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Now a real conundrum....

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Alright I'll take a stab it it. I would want to know the following,

Vital signs, Allergies to anything..including enviromental, does he

take any medications, OTC medications, herbs/suppliments/vitamins?,

has he had any medical problems, has he had any surgeries,

hospitalizations? blood transfusions..what kind/how much/when?, Last

medical check up, routine health care? has the facility recently

started using a new product...food, chemical? has the pt. recently

started using any new products? Family history...father, mother,

grandparents, aunts, uncles, brothers, sisters? Tobacco use? how

much/what kind/how often? Substance abuse? how much/what kind/how

often? Social history...what does he do? is he married? kids? where

does he live? Stressors, support system, sexual practices, exercise,

diet, sexual orientation, religion, hobbies, military service?

changes in bowel/bladder habits?blood/mucous/drainage in

stool/urine? What brings it on, what aggrivates it, what alleviates

it, is it progressing/regressing/steady? any pain anywhere? recent

fall/trauma?

General mood; race; skin- rashes, scars, tattoos, moles, hair

pattern; lymph nodes - head/neck, axillary to include

tenderness/size; HEENT- Head - shape/size, tenderness, Eyes-

ractive, visual fields/acuity, movements, Ears- test hearing,

tenderness, discharge, TM intact?, Nose- lesions, inflammation,

Throat- pharynx, tongue, gums, teeth, lips - presence of lesions,

exudate, erythema; neck - JVD, ROM, TD, Chest- symmetry with

resipration, tenderness, lungs-??, Heart tones- ??; Abdomen - scars,

shape, bowel sounds, percussion, tenderness, masses?; Pelvis - any

changes in genitalia...lesions, swelling, hernia? hemorrhoid;

Extermities- pulses, skin color, edema?; Neurological -- Blood sugar

check, sense of smell, visual fields, eye movement, bite down, show

teeth/smile, hear watch tick/finger rub, speech- clear, slurred,

stick tongue out; motor strength test, heel-toe walking, rapid

alternating movements of upper and lower extermities; Check sensory

with sharp/dull object on upper/lower extermities/body parts; Mini

mental state exam

CBC, Chem, LFT, Tox. Screen, 12 lead ECG, BGL, UA, STD screen,

Once I had that information back then I could take a gander at what

it might be.

Vaughn

Vaughn EMT-P/Instructor

>

> Now a real conundrum....

>

>

>

> Several years ago a family from New York moves to your town and

opens the

> best Italian restaurant in town. The owners are friendly second-

generation

> Italian-Americans and the food is as good as you can get in New

York City.

> The restaurant is popular with EMS crews. One day, one of the two

co-owners

> of the restaurant comes to the table and asks questions about his

brother

> . is 48-years-old and, approximately four months, began

to have

> problems sleeping. Later he developed panic attacks and developed

a morbid

> fear of dead human bodies and yellow cheese. Lately, has

gotten worse.

> He rarely sleeps and is now having increased panic attacks, vivid

> hallucinations, becomes easily agitated and sweats copiously at

times.

> Interestingly, he does not produce tears any more and his eyes are

very dry

> and he is constantly scratching them or instilling Murine eye

drops. He also

> has diminished pain perception and has burned himself several

times in the

> kitchen, His brother Luigi is very concerned about and

wonders if you

> know what might be wrong with him.

>

> What is wrong with ?

>

>

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nil

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of shah_emt

Sent: Saturday, July 15, 2006 10:51 PM

To: texasems-l

Subject: Re: Now a real conundrum....

What is his Lithium level?

Shahla

Several years ago a family from New York moves to your town and

> opens

> > the

> > best Italian restaurant in town. The owners are friendly

second-generation

> > Italian-Americans and the food is as good as you can get in New

York City.

> > The restaurant is popular with EMS crews. One day, one of the two

> co-owners

> > of the restaurant comes to the table and asks questions about his

brother

> > . is 48-years-old and, approximately four months, began

to have

> > problems sleeping. Later he developed panic attacks and developed

a morbid

> > fear of dead human bodies and yellow cheese. Lately, has gotten

> worse.

> > He rarely sleeps and is now having increased panic attacks, vivid

> > hallucinations, becomes easily agitated and sweats copiously at times.

> > Interestingly, he does not produce tears any more and his eyes are

very

> dry

> > and he is constantly scratching them or instilling Murine eye

drops. He

> also

> > has diminished pain perception and has burned himself several

times in the

> > kitchen, His brother Luigi is very concerned about and

wonders if

> you

> > know what might be wrong with him.

> >

> > What is wrong with ?

> >

> >

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Neither

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of shah_emt

Sent: Saturday, July 15, 2006 10:58 PM

To: texasems-l

Subject: Re: Now a real conundrum....

I am tending towards hyperthyroidism or Bipolar Disorder or both.

Shahla

Several years ago a family from New York moves to your town and

> opens

> > the

> > best Italian restaurant in town. The owners are friendly

second-generation

> > Italian-Americans and the food is as good as you can get in New

York City.

> > The restaurant is popular with EMS crews. One day, one of the two

> co-owners

> > of the restaurant comes to the table and asks questions about his

brother

> > . is 48-years-old and, approximately four months, began

to have

> > problems sleeping. Later he developed panic attacks and developed

a morbid

> > fear of dead human bodies and yellow cheese. Lately, has gotten

> worse.

> > He rarely sleeps and is now having increased panic attacks, vivid

> > hallucinations, becomes easily agitated and sweats copiously at times.

> > Interestingly, he does not produce tears any more and his eyes are

very

> dry

> > and he is constantly scratching them or instilling Murine eye

drops. He

> also

> > has diminished pain perception and has burned himself several

times in the

> > kitchen, His brother Luigi is very concerned about and

wonders if

> you

> > know what might be wrong with him.

> >

> > What is wrong with ?

> >

> >

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Ahh, finally a great, accurate clinically sound diagnosis.

-Wes

In a message dated 7/17/2006 8:06:14 PM Central Daylight Time,

TranquilityBase34@... writes:

He is Nutzo McGoofey....He

>From: " Bledsoe " <_bbledsoe@..._

(mailto:bbledsoe@...) >

>Reply-To: _texasems-l@yahoogrotexasem_ (mailto:texasems-l )

>To: <_texasems-l@yahoogrotexasem_ (mailto:texasems-l ) >

>Subject: Now a real conundrum...S

>Date: Fri, 14 Jul 2006 21:22:58 -0500

>

>Several years ago a family from New York moves to your town and opens the

>best Italian restaurant in town. The owners are friendly second-generation

>Italian-Americans and the food is as good as you can get in New York City.

>The restaurant is popular with EMS crews. One day, one of the two co-owners

>of the restaurant comes to the table and asks questions about his brother

>. is 48-years-old and, approximately four months, began to have

>problems sleeping. Later he developed panic attacks and developed a morbid

>fear of dead human bodies and yellow cheese. Lately, has gotten

>worse.

>He rarely sleeps and is now having increased panic attacks, vivid

>hallucinations, becomes easily agitated and sweats copiously at times.

>Interestingly, he does not produce tears any more and his eyes are very dry

>and he is constantly scratching them or instilling Murine eye drops. He

>also

>has diminished pain perception and has burned himself several times in the

>kitchen, His brother Luigi is very concerned about and wonders if

>you

>know what might be wrong with him.

>

>

>

>What is wrong with ?

>

>

>

>[Non-text portions of this message have been removed]

>

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He is Nutzo McGoofey....lol

>

>Reply-To: texasems-l

>To: <texasems-l >

>Subject: Now a real conundrum....

>Date: Fri, 14 Jul 2006 21:22:58 -0500

>

>Several years ago a family from New York moves to your town and opens the

>best Italian restaurant in town. The owners are friendly second-generation

>Italian-Americans and the food is as good as you can get in New York City.

>The restaurant is popular with EMS crews. One day, one of the two co-owners

>of the restaurant comes to the table and asks questions about his brother

>. is 48-years-old and, approximately four months, began to have

>problems sleeping. Later he developed panic attacks and developed a morbid

>fear of dead human bodies and yellow cheese. Lately, has gotten

>worse.

>He rarely sleeps and is now having increased panic attacks, vivid

>hallucinations, becomes easily agitated and sweats copiously at times.

>Interestingly, he does not produce tears any more and his eyes are very dry

>and he is constantly scratching them or instilling Murine eye drops. He

>also

>has diminished pain perception and has burned himself several times in the

>kitchen, His brother Luigi is very concerned about and wonders if

>you

>know what might be wrong with him.

>

>

>

>What is wrong with ?

>

>

>

>

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Over use of amphetamines....or Donkey Kong finally got to him.. If it is

amphetamines, possibly is to has not aclimatized to the pollens in Texas,

and is taking too many OTC psuedaphed. Or....possibly the stress of being away

from NYC maybe has driven him to patronize a local meth cooker around Lake

Tawakoni to get methampetamines.

-MH

>

>Reply-To: texasems-l

>To: <texasems-l >

>Subject: Now a real conundrum....

>Date: Fri, 14 Jul 2006 21:22:58 -0500

>

>Several years ago a family from New York moves to your town and opens the

>best Italian restaurant in town. The owners are friendly second-generation

>Italian-Americans and the food is as good as you can get in New York City.

>The restaurant is popular with EMS crews. One day, one of the two co-owners

>of the restaurant comes to the table and asks questions about his brother

>. is 48-years-old and, approximately four months, began to have

>problems sleeping. Later he developed panic attacks and developed a morbid

>fear of dead human bodies and yellow cheese. Lately, has gotten

>worse.

>He rarely sleeps and is now having increased panic attacks, vivid

>hallucinations, becomes easily agitated and sweats copiously at times.

>Interestingly, he does not produce tears any more and his eyes are very dry

>and he is constantly scratching them or instilling Murine eye drops. He

>also

>has diminished pain perception and has burned himself several times in the

>kitchen, His brother Luigi is very concerned about and wonders if

>you

>know what might be wrong with him.

>

>

>

>What is wrong with ?

>

>

>

>

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