🚀 go-pugleaf

In article <5ct84c$oe4@news1.iamerica.net>, Krin135@AOL.com says...
>
>(case H&P snipped)
In addition to Dr. Canning's question list:
>
>Question 1: What other information do you want to get from the mother
>or the visiting nurse?

Has paroxysmal nocturnal dyspnea been noted?
Hx of bleeding disorders? (though that surely would have been 
mentioned...)
>
>Question 2: How fast do you want to get this patient to the hospital?
>
Rapid transport

>Question 3: What would your first treatment be?

Oxygen, high flow; venous access (after blood sample) with volume 
expander KVO for now, cardiac monitoring

>Question 4: (for advanced credit...) What is your differential list of
>problems (diagnosis list) at this time.

To Dr Cannings list, add: pulmonary embolus (even though S/S suggest a 
problem of clotting factors and vascular integrety)  Also: rule out 
disseminated intravascular coagulation (DIC).  Longshot: CHF secondary 
to cardiomyopathy?

>Hint: When you hear hoofbeats, look for horses, but occasionally
>zebras will show up.

*I'd* be concerned if I showed up on a run like that. Anxiously awaiting 
the dx and remainder of the case study...