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Andrew M. Ball PT PhD -> Re: Case (March 24, 2005 1:24:00 AM)
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Wouldn't we start with a general health screening? Ask questions about fatigue, malaise, weakness, chills/fever/low grade fever of more than 100 that lasted for more than 2 weeks, unexplalined weight loss/gain of more than 5% body weight, nausea, or parathesia?
The answers to these questions aren't going to be all that sensitive, but they are the are the initial medical screening questions taught in just about any DPT program. They will begin to clue a clinician in to organ system dysfunctions ranging from depression/anxiety, to infection, to liver disfunction, to cancer, to rheumatic disorders.
With orthostatic hypotension, and weakness we'd also want to subjectively screen the cardiovascular, pulmonary, GI, and endocrine systems. So, patient, any dyspnea, orthopenea, palpitations, pain/sweats, suncope, peripheral edema or cough? Any Tachypenea, Hemoptysis, Sputum, stridor, wheezing or clubbing? Any Nausea, vomiting, heartburn? Constipation, changes in bowel color, caliber, continence, constipation? Finally, any arthralgia, myalgia, muscle cramps, heat/cold intolerance, skin or hair changes? Finally, what medications is the guy taking? Corticosteriods, Beta-Blockers, Ca Channel Blockers, ACE Inhibitors, Diuretics, and Digoxin can all cause general muscle weakness, and (I THINK, but don't remember, would have to look up) more than a few can have orthostatic hypotension as a side effect.
Drew
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