Guest guest Posted February 25, 2009 Report Share Posted February 25, 2009 Close. But we're just floundering about here, folks. Fugu is a neurotoxic poison. Does that fit Mrs. Wu's situation? I think not. What causes hyperkalemia and the other S/S she's having? Now's the time to think critically. GG > > > maybe puffer fish?? > > > > > > > From: wegandy1938@wegandy > > > Subject: Hello boys and girls > > > To: texasems-l@yahoogrotexasem, > > Paramedicine@ParamedicinePar > > > Date: Wednesday, February 25, 2009, 12:23 AM > > > Hi, boys and girls. Uncle Gene has another puzzler > > for > > > you. Can you say > > > PUZZLER? I thought you could! > > > > > > Now, for the winners, The Inn At Ladonia is booked > > solid > > > until the 2012 > > > elections, since with the economic downturn the > > Captains of > > > Industry lack the bucks > > > to stay at the Ritz-Carlton and would be too > > embarrassed to > > > spend the money > > > to stay there even if they had it. So they are > > visiting > > > The Inn and taking in > > > the local flavor, including the fumes from the hog > > > rendering plant, which is > > > the pride of Ladonia. > > > > > > However, I do have a little rent house in Honey Grove, > > TX, > > > just 10 miles > > > north, that you can occupy for a week. At one time > > the > > > next door neighbor had a > > > huge marijuana plant growing just across the fence, > > but I > > > make no warranties > > > about that. If you win, you're on your own. > > Points > > > of interest are the > > > State Prison in Bonham, and the......... State Pri > > get > > > back to you on the rest of > > > them. > > > > > > Now, here's the scenario. > > > > > > You and your partner respond to a call for an > > " unknown > > > emergency " at a > > > residence in one of the very upscale and saddiddy > > > neighborhoods of your town. > > > Dispatch says that they are having trouble > > understanding > > > the caller, since she > > > does not speak English well, and they are attempting > > to get > > > Language Line up and > > > will give you more information as they get it. > > > > > > Before receiving any more information you arrive at > > the > > > address on Orchid > > > Lane. It's a very large and expensive house, and > > > there are a couple of Mercedes > > > cars in the drive. The cops are also there, and they > > > knock on the door. > > > It opens and a very concerned young lady opens it and > > says > > > that her aunt is > > > having a hard time breathing and experiencing chest > > pain. > > > > > > You enter and find an elderly Asian woman lying on a > > very > > > expensive sofa in > > > the opulent living room. The young lady introduces > > > herself as the niece of > > > the elderly lady, and she speaks excellent English. > > She > > > eexplains that her > > > aunt just arrived from Taiwan this morning after an 18 > > hour > > > flight, and had gone > > > to bed to rest, but woke with chest pain, difficulty > > > breathing, sweating, and > > > nausea. Her mother, who speaks little English, has > > called > > > 911 and also > > > called her at her job at Bank of America in the loan > > > department, and she > > > immediately came home. > > > > > > As you begin your examination of the woman, you find > > the > > > following: > > > > > > Pulse 38 and irregular > > > BP 82/54 > > > Respirations 30 and clear, but patient seems to be > > very > > > apprehensive > > > Temperature 97.4 > > > PaO2 96% > > > Obvious increased salivation > > > > > > As you question your patient through her niece, you > > find > > > that she had > > > celebrated her 77th birthday in Taiwan, just before > > > leaving. There was a large > > > birthday party with many relatives and friends, and a > > large > > > dinner of regional > > > dishes and delicacies just before she left for the US > > to > > > spend a month with her > > > sister. > > > > > > Since chest pain is reported, you hook your patient up > > to > > > the monitor and see > > > what appears to be a Mobitz II 2:1 AV block, with an > > atrial > > > rate of about 80 > > > and a ventricular rate of about 40. > > > > > > Your patient denies that she takes any medications. > > She > > > maintains that she > > > has been in excellent health all her life and only > > became > > > sick during the > > > plane ride. She says that she blames her illness > > on the > > > " bad air " in the > > > plane. > > > > > > You and your partner decide to do a 12-lead and find > > that > > > she has a Mobitz II > > > 2:1 AV block, a PR interval of 220 ms, a rate of 40, > > and > > > tall, peaked T-waves > > > in Leads V1, V2, V3, and V4, which are actually taller > > than > > > the preceding QRS > > > complexes. They look just like church steeples. > > > > > > What additional questions would you ask? > > > > > > What interventions should you consider? > > > > > > Although you do not have access to laboratory tests in > > the > > > field, your > > > partner, who has spent a lot of time in Asia in the > > > military, says he thinks he > > > knows what might be the cause of this patient's > > > condition. > > > > > > What does he think the cause might be? > > > > > > GG > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ************ * > > > Get a jump start on your taxes. Find a tax > > professional in > > > your > > > neighborhood today. > > > > > (http://yellowpages.http://yellowpahttp://yelhttp://yellowpaghttp://yellow& > amp; amp;ncid= > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 25, 2009 Report Share Posted February 25, 2009 Close. But we're just floundering about here, folks. Fugu is a neurotoxic poison. Does that fit Mrs. Wu's situation? I think not. What causes hyperkalemia and the other S/S she's having? Now's the time to think critically. GG > > > maybe puffer fish?? > > > > > > > From: wegandy1938@wegandy > > > Subject: Hello boys and girls > > > To: texasems-l@yahoogrotexasem, > > Paramedicine@ParamedicinePar > > > Date: Wednesday, February 25, 2009, 12:23 AM > > > Hi, boys and girls. Uncle Gene has another puzzler > > for > > > you. Can you say > > > PUZZLER? I thought you could! > > > > > > Now, for the winners, The Inn At Ladonia is booked > > solid > > > until the 2012 > > > elections, since with the economic downturn the > > Captains of > > > Industry lack the bucks > > > to stay at the Ritz-Carlton and would be too > > embarrassed to > > > spend the money > > > to stay there even if they had it. So they are > > visiting > > > The Inn and taking in > > > the local flavor, including the fumes from the hog > > > rendering plant, which is > > > the pride of Ladonia. > > > > > > However, I do have a little rent house in Honey Grove, > > TX, > > > just 10 miles > > > north, that you can occupy for a week. At one time > > the > > > next door neighbor had a > > > huge marijuana plant growing just across the fence, > > but I > > > make no warranties > > > about that. If you win, you're on your own. > > Points > > > of interest are the > > > State Prison in Bonham, and the......... State Pri > > get > > > back to you on the rest of > > > them. > > > > > > Now, here's the scenario. > > > > > > You and your partner respond to a call for an > > " unknown > > > emergency " at a > > > residence in one of the very upscale and saddiddy > > > neighborhoods of your town. > > > Dispatch says that they are having trouble > > understanding > > > the caller, since she > > > does not speak English well, and they are attempting > > to get > > > Language Line up and > > > will give you more information as they get it. > > > > > > Before receiving any more information you arrive at > > the > > > address on Orchid > > > Lane. It's a very large and expensive house, and > > > there are a couple of Mercedes > > > cars in the drive. The cops are also there, and they > > > knock on the door. > > > It opens and a very concerned young lady opens it and > > says > > > that her aunt is > > > having a hard time breathing and experiencing chest > > pain. > > > > > > You enter and find an elderly Asian woman lying on a > > very > > > expensive sofa in > > > the opulent living room. The young lady introduces > > > herself as the niece of > > > the elderly lady, and she speaks excellent English. > > She > > > eexplains that her > > > aunt just arrived from Taiwan this morning after an 18 > > hour > > > flight, and had gone > > > to bed to rest, but woke with chest pain, difficulty > > > breathing, sweating, and > > > nausea. Her mother, who speaks little English, has > > called > > > 911 and also > > > called her at her job at Bank of America in the loan > > > department, and she > > > immediately came home. > > > > > > As you begin your examination of the woman, you find > > the > > > following: > > > > > > Pulse 38 and irregular > > > BP 82/54 > > > Respirations 30 and clear, but patient seems to be > > very > > > apprehensive > > > Temperature 97.4 > > > PaO2 96% > > > Obvious increased salivation > > > > > > As you question your patient through her niece, you > > find > > > that she had > > > celebrated her 77th birthday in Taiwan, just before > > > leaving. There was a large > > > birthday party with many relatives and friends, and a > > large > > > dinner of regional > > > dishes and delicacies just before she left for the US > > to > > > spend a month with her > > > sister. > > > > > > Since chest pain is reported, you hook your patient up > > to > > > the monitor and see > > > what appears to be a Mobitz II 2:1 AV block, with an > > atrial > > > rate of about 80 > > > and a ventricular rate of about 40. > > > > > > Your patient denies that she takes any medications. > > She > > > maintains that she > > > has been in excellent health all her life and only > > became > > > sick during the > > > plane ride. She says that she blames her illness > > on the > > > " bad air " in the > > > plane. > > > > > > You and your partner decide to do a 12-lead and find > > that > > > she has a Mobitz II > > > 2:1 AV block, a PR interval of 220 ms, a rate of 40, > > and > > > tall, peaked T-waves > > > in Leads V1, V2, V3, and V4, which are actually taller > > than > > > the preceding QRS > > > complexes. They look just like church steeples. > > > > > > What additional questions would you ask? > > > > > > What interventions should you consider? > > > > > > Although you do not have access to laboratory tests in > > the > > > field, your > > > partner, who has spent a lot of time in Asia in the > > > military, says he thinks he > > > knows what might be the cause of this patient's > > > condition. > > > > > > What does he think the cause might be? > > > > > > GG > > > > > > > > > > > > > > > > > > > > > > > > > > > > > > ************ * > > > Get a jump start on your taxes. Find a tax > > professional in > > > your > > > neighborhood today. > > > > > (http://yellowpages.http://yellowpahttp://yelhttp://yellowpaghttp://yellow& > amp; amp;ncid= > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.