Case - Unconscious, worked under very hot conditions.
Hints page


 

I. The Case (& preliminary "hints")

Case - Unconscious, worked under very hot conditions.


II. The Chart

We note above 1) a very serious hypotension 2) a tachycardia 3) a low body weight 4) a fever 5) sweating and 6) periodic loss of consciousness.

Plus, when conscious, Sullivan reports of dizziness, extreme thirst and and feeling poorly.


III. The output data table

The initial vital signs data table confirms many of the observations above.


IV. Other -

A] Examing variables via tabular/graphic output

The combination of the history ("worked under very hot conditions") and the vital signs lead one to suspect severe water and perhaps salt loss during work.

Setup - We probe for signs of this by resetting our View output: tables/plots to monitor for the water/salt status of the patient as below.

These variable above are, left to right, mean arterial pressure (AP, mmHg), blood volume (BV), plasma osmolarity (POSM, mOsm/l), urine osmolarity (UOSM), plasma [Na] (PNA, mEq/L) and the excretion rate of sodium (EXNA, mEq/min).


Output - The output for such a set of tables, in an experiment run for 0 min. with 0 min. between readouts is shown below.

Some questions to ask here include

• is this a normal blood volume?

• what does the combination of this level of plasma osmolarity and urine osmolarity indicate?

• is this a normal level of plasma Na and how does the urinary excretion pattern of Na fit into the picture?


B] Examing Blood Chemistry readouts

Setup - Blood Chemsitry may be read out by simply asking (see below) for that readout in the above experimental run.

Output - The resulting readout is shown below.

This readout reveals some of the same trends cited in the tabular data above in section A.



V. More

This ends the hints section on this case.

You should attempt again at this point to arrive at a diagnosis and a treatment. To do so

Return to the HUMAN model's Physiology Lab section for this patient and verify

- the diagnosis by finding the appropriate variables to support your argument and

- the treatment by changing parameters so as to stabilize the patient.


VI. Analysis

If you wish further analysis and a diagnosis on this case and information on how it was created, click on this link ( analysis ) and log in as requested.

* Note: Case hints and analyses are based heavily on Drs. Randall and Coleman's HUMAN-80 Instructor's Manual supplemented by notes of Dr. Coleman's in the model code itself and findings by myself and other colleagues over our years of use of these cases.