Can a doctor tell...

[TheFonz]

Please correct me if I'm wrong, but an ER doc I shadowed told me that as soon as you register at triage, they bill OHIP (or your provincial equivalent) something like 400-500 dollars for each patient. And that cost doesn't go away even if you bail without being seen. Just for all you fakers out there

 

Noodle: Hilarious story! I'll give you credit for posting that lol.

[Starling]

Noodle: Hilarious story! I'll give you credit for posting that lol.

 

Yeah, thanks for the laugh!

 

Hopefully you scared some people away from faking symptoms!

[UTPEOPLE]

Oh, I sure did!

 

OOO... you can use this as one of those "how did I mature over the years" question answer!

[xi88]

At the health clinic at on Dal campus, the doctors will see you, but a note costs ~$20 regardless whether or not you're faking. Their reason, notes are not covered by MSI.

[leviathan]

Well... let's see.

 

You have diarrhea and have been vomiting.

 

You lose fluid (hypovolemia), and you lose bicarbs. Your heart rate will increase to increase the cardiac ouput to sustain BP.

 

Due to the loss of bicarb, your body will try to compensate for the acidosis by breathing faster. Your respiration may be shallow.

 

I would probably auscultate and palpate your abdomen to see if you have a major problem.

 

I would also listen for hyperactivity and the pattern.

 

I'm sure that experienced physicians can tell up to some extent.

 

Welcome to premed101.

A combination of diarrhea AND vomiting is going to cause loss of both bicarb and acids, so in a way that would cancel the effects of each. However you could get alkalosis from the effects of volume contraction.

[leviathan]

Yeah medical notes are not covered by medicare at least not in BC...

[mrnursing]

A combination of diarrhea AND vomiting is going to cause loss of both bicarb and acids, so in a way that would cancel the effects of each. However you could get alkalosis from the effects of volume contraction.

 

Nice catch. I missed out on the acid loss part by vomiting.

 

It also depends on # and amount of vomit and diarrhea.

 

Since he is vomiting and having diarrhea, you'll have interstitial fluid moving in to restore fluid volume.

 

However, since it's not much (interstitial fluid), I know that you'll probably see an increase in renin secretion and angiotension II and aldosterone (increased K+ secretion) formation to decrease the urinary output and increase bicarb reabsorption when you start to lose a lot fluid.

 

For hypovolemia, you'll see increased heart rate, soft sunken eyeballs, dry mucous membranes, lethargy, flat neck veins... all depending on how much fluid you've lost.

 

Even if there is a cancellation due to:

 

Metabolic alkalosis results from elevated serum bicarb level... vomiting, overdiuresis, ascites, hypokalemia, alkali ingestion, excess gluco- or mineralcorticoids contributes to its cause. Since he had diarrhea, he is losing a lot of bicarb as well. Possible cancellation?

 

With hypovolemia, you may have increased respiratory rate or tachypnea. Respiratory alkalosis may occur from hyperventilation.

 

Compensatory mechanism for resp alkalosis may become impeded due to the vomiting and diarrhea problems?

 

Can we also look at clinical manifestation of hypokalemia? Both vomiting and diarrhea may cause hypokalemia.

 

For hypokalemia, you may see decrease in neuromuscular excitability.

 

He may have skeletal muscle weakness and cardiac arrhythmias.

 

In conclusion, I guess there is a number of ways of seeing if the guy is faking or not.

[infomeddude]

Nice catch. I missed out on the acid loss part by vomiting.

 

It also depends on # and amount of vomit and diarrhea.

 

Since he is vomiting and having diarrhea, you'll have interstitial fluid moving in to restore fluid volume.

 

However, since it's not much (interstitial fluid), I know that you'll probably see an increase in renin secretion and angiotension II and aldosterone (increased K+ secretion) formation to decrease the urinary output and increase bicarb reabsorption when you start to lose a lot fluid.

 

For hypovolemia, you'll see increased heart rate, soft sunken eyeballs, dry mucous membranes, lethargy, flat neck veins... all depending on how much fluid you've lost.

 

Even if there is a cancellation due to:

 

Metabolic alkalosis results from elevated serum bicarb level... vomiting, overdiuresis, ascites, hypokalemia, alkali ingestion, excess gluco- or mineralcorticoids contributes to its cause. Since he had diarrhea, he is losing a lot of bicarb as well. Possible cancellation?

 

With hypovolemia, you may have increased respiratory rate or tachypnea. Respiratory alkalosis may occur from hyperventilation.

 

Compensatory mechanism for resp alkalosis may become impeded due to the vomiting and diarrhea problems?

 

Can we also look at clinical manifestation of hypokalemia? Both vomiting and diarrhea may cause hypokalemia.

 

For hypokalemia, you may see decrease in neuromuscular excitability.

 

He may have skeletal muscle weakness and cardiac arrhythmias.

 

In conclusion, I guess there is a number of ways of seeing if the guy is faking or not.

 

RN candidate? Or MD Candidate?