Any one know what these symptoms mean?

[Old_School]

Who exactly is assuming this person is a man. Both WR and myself said he/she. Only NH said he. Is that who you are talking about?

[WRRN]

I don't see many reasons for liver involvement. DM is by far the largest contributor to ESRD. A renal panel will shed the most light on this subject quickly. I'd like to see some vital signs and a blood sugar but I'll go with all the subjective s/s on this one and bet the farm even. Where is the OP and does he have an answer?


WR,,, three commas for Becca

I will temper one response of mine about the severe leg/back pain relieved with rest to diabetic neuropathy again a precussor to ESRD.

Did you want me to guess on the patient's ethnic background, sex, and age also because I could pull up the stats on that too although I probably wouldn't need to.

[lam]

I would love to know what you come up with as far as ethnic, sex and age.
I was looking for some causes, I never thought about lead posioning, unlikely but could be another type of posioning. If it is a toxic chemical than the tx would be to remove the toxin. Chromium is a possibility and could be a multitude of others. Also this person was exposed to an illegal pesticide years ago. Need more research to see what the damage is from that. So before we whip this person into dialysis I want to explore all avenues. Thank you for your input. Please feel free to let me know if you think of anything else that could be contributing.

[WRRN]

Renal profile will determine dialysis. The sum total of the symptoms point to CKD if not ESRD. And I've seen lead poisoning years ago in NC.. Didn't present like that at all..

It's renal failure. Pure and simple.

WR,,, three commas for Becca

Do you know the answer or is this all speculation?

P.S. ESRD is pretty toxic BTW...

[WRRN]

Of course the kidney failure could be caused by some type of poisoning.. Unlikey but not out of the question. Usually, poisoning of any degree would be instanteous and much more critical. 3-4+ edema takes some time. Chronic cough could be from ACE inhibitors if this patient is being followed for DM.. ACE inhibitors have been shown to preserve kidney function. Not reverse it or deter it totally.

The blurred vision still leads me to DM Type II.

And the PE I spoke of is not Pulmonary Embolism but Pleural Effusion.. Sorry if that was unclear.

WR,,, three commas for Becca

The cause here is not the overriding issue; getting diagnosised properly and treated appropriately is.

Actually, now that I think of it this was the first scenario of Pathophysiology 101 and I "guessed" correctly that time too. Although this and that were far from guesses.

[Old_School]

This discussion reminds me of the endless speculation of a patient's diagnosis on the basis of a Lead II Ekg Rythmn Strip. I came to realize then that diagnosing a patient using a rhythmn strip is about as useful as determining a woman's breast size by looking at a picture of her nose. I am also wondering if Iam has the answer and is just playing us.

O_S

[WRRN]

I think we have slightly more to go on than one lead.


I don't know if it's a test question or a real patient.

I don't really care. I like the mystery though.

Hopefully we'll get an answer soon from the OP.


WR,,, three commas for Becca

[Old_School]

[ QUOTE ]
lam said:
I would love to know what you come up with as far as ethnic, sex and age.


[/ QUOTE ]


YGTBSM

[WRRN]

Ethnic #1 African American. #2 Native American.

Sex Male

Age 67.

WR,,, three commas for Becca

[lam]

This isn't coming from patho 101. The problem is that the symptoms come and go.Years ago this person inhaled a large amt. of an illegal pesticide, some time after that developed a stiff neck that continued down the shoulder developing into severe muscle spasms. This all lasted about 3 weeks was diagnosed as tendenitis. the above symptoms begin slowly and keep getting worse then everything reverses itself and the cycle starts all over. as the edema increases so does the blurred vision and all the other symptoms.