| QUIZ: Candlelight dinner *solved* |
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| Thursday, 10 December 2009 23:15 |
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Case description: A call to a private apartment, 10th floor. The door is opened by an attractive, elegant woman. There is an unconscious man lying in a room, about 36 years old. Glasgow scale - 8, pale integuments, tachycardia 140/min, fast and weak pulse. Drops of sweat on the forehead. One thing drawing attention is a rectangular patch strapped to his sternum. According to the woman they were eating dinner together and drinking wine. Later on the man went to the bathroom and afterwards he became pale, started to hyperventilate and fell from the chair on the floor. The doctor recognizes the symptoms of a shock. We assume that the paramedics did their job flawlessly What is this quiz about: we are looking for the CAUSE of such state. What are your suspicions? What do we look for, where? |
Comments
P.S. least i forget... How old was this woman? Was she a blond or a brunette? ;-)
she was a REDHEAD! :-)
-->What did they have for dinner?
The food was ordered from a nearby restaurant.
Some salmon dish, difficult to say. We can see almonds, asparagus, some kind of sauce on the plate, white wine - semi-fortified
-->Anything more about this patch? Was he suffering from any diseases?
The woman states that her colleague was always strong and healthy, he does sports, has occasional cardiological visits
Good lead, the patch is the key. The guy doesn't smoke, never has. We can also exclude neoplasm pains. What other drugs can be administered in such a way?
There is no documentation because the apartment belongs to the woman. They are work colleagues
-->But as adam has pointed out, these are just pure divagations.
The whole point with this case is that we don't have any diagnostic to work with, but then again, lab tests which we would have done in the hospital would not shine much light on this. Its a bit of a detective work. The solution is right here in the flat, you have to figure out where to look.
It's like this... The guy has nitroglycerin in that patch.. He went to the bathroom and took anyone of the phosphodiestera se type 5 inhibitors (e.g. Viagra) hoping for a ravishing evening with his work colleague. Both of those drugs dilate blood vessels and our 36 years old impotent dropped his blood pressure to the max :-)
Heh... and they always tell you to read the instructions or to consult with your doctor before taking any medication :D
But do admit that the my reasoning is worthy of his magnificence House MD ;-) ;-)
To check whether he took Viagra... I'd look down there ;-)
Adam has hit the bullseye -
The poor fellow is suffering from a Prinzmetal's angina, which is treated with nitrates, hence the patch. Impotence can occur even around this age. Taking a blue pill: desperate measure with a poor finale.
Jamjestdina: Regarding your scenario - giving the patient nitrolingual will most likely result in a cardiac arrest.
Taking nitrates is an absolute contraindicatio n to taking sildenfil.
How do you like the case?
It's a shame it's been solved so quickly. I guess I gave out too many clues...
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