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One of the other threads got me thinking of a call I ran a while back. Unfortunately I don't have all of the details to this call as it was probably five years ago. But maybe someone smarter than me has some ideas.
Got called for a general "sick person" a couple years ago. Upon arrival, an approximately 50yo Caucasian woman and her husband meet us inside their clean, well-kept apartment. Right off the bat the lady is severely jaundiced. I've seen jaundice countless times, but this was different. This lady looked borderline Oompa Loompa.
Aside from the jaundice, her only complaint was feeling lightheaded, especially when standing up. Vitals when sitting were roughly 100/60 with a heart rate around 90. When standing her BP dropped to 70/40 with her HR jumping to 120. So certainly some orthostatic changes. BGL was normal, as were her O2 sats. Afebrile.
The patient denies any medical history. States she sees her PCP regularly but has always been relatively healthy. No meds. Non-smoker. Drinks an occasional glass of wine or two, but denies being a heavy drinker. She had no other complaints. No abdominal pain.
What really threw me off, the jaundice and lightheaded both came on overnight. She went from a fair-skinned white lady to a hypotensive Willy Wonka worker literally overnight. The patient and her husband both came off as reliable and gave no indication of trying to hide something (yes, I know, all patients lie).
The only things I could come up with is maybe something like Hep A. I had also only been a medic for two years at the time, so I wouldn't put it past me to have missed something significant...
Any thoughts? Unfortunately I don't have any further information.
Got called for a general "sick person" a couple years ago. Upon arrival, an approximately 50yo Caucasian woman and her husband meet us inside their clean, well-kept apartment. Right off the bat the lady is severely jaundiced. I've seen jaundice countless times, but this was different. This lady looked borderline Oompa Loompa.
Aside from the jaundice, her only complaint was feeling lightheaded, especially when standing up. Vitals when sitting were roughly 100/60 with a heart rate around 90. When standing her BP dropped to 70/40 with her HR jumping to 120. So certainly some orthostatic changes. BGL was normal, as were her O2 sats. Afebrile.
The patient denies any medical history. States she sees her PCP regularly but has always been relatively healthy. No meds. Non-smoker. Drinks an occasional glass of wine or two, but denies being a heavy drinker. She had no other complaints. No abdominal pain.
What really threw me off, the jaundice and lightheaded both came on overnight. She went from a fair-skinned white lady to a hypotensive Willy Wonka worker literally overnight. The patient and her husband both came off as reliable and gave no indication of trying to hide something (yes, I know, all patients lie).
The only things I could come up with is maybe something like Hep A. I had also only been a medic for two years at the time, so I wouldn't put it past me to have missed something significant...
Any thoughts? Unfortunately I don't have any further information.
