PUZZLE: Need diagnosis help #2

[SplshMtn99]

http://www.geocaching.com/seek/cache_details.aspx?guid=65408728-d6ad-4fb1-8181-7db9ed1688f2

Since I know absolutely NOTHING about medicine, and the DIS seems to have lots of doctor wanna be's, I thought this was a good place to ask for help.

The final result is in the form of numbers / coordinates. I'm guessing that diagnosis' have numbers?

(THERE WILL BE 2 OF THESE PUZZLES GOING AT THE SAME TIME. THIS IS #2).
Here is the other puzzle thread if interested. http://www.disboards.com/showthread.php?t=2000802

 

[dare2dream]

Link did not work for me. It said I needed to be logged in.

 

[SplshMtn99]

***** edited to delete puzzle since its solved ****

 

[TinkerbEllnor]

Can I guess? Lockjaw/Tetanus? I don't know anything about geocaching, so that's about all I can offer.

At a minimum, it's a bump for you...

 

[Connieh]

Hi,

I would go with bacterial disease, the incubation period for tetanus is 3 days to 3 weeks, so that fits.

The difficulty swallowing would also fit this diagnosis.

A common first sign of tetanus is muscular stiffness in the jaw (lockjaw), followed by stiffness of the neck, difficulty in swallowing, rigidity of abdominal muscles, spasms, sweating and fever.

Good luck,

Connie

 

[SplshMtn99]

I'm hoping for a blizzard so I can sit down & study everything on both puzzles & what people are posting. I haven't a clue on either of them. Medicine is NOT my thing.

 

[MagiKitty]

I'm going to guess rabies. He was bit by a bat in the cave. Aversion to water and difficulty swallowing are classic clues.

I don't know about the numbers/coordinates. Sorry. I'll look at it later.

 

[SplshMtn99]

The other puzzle is solved, now I can start on this one. I'll be getting back to you because I'm sure I'll have more questions for the individual answers needed to actually solve the puzzle.

 

[christiane]

Smile and jaw opening
Chvostek’s sign
Temporomandibular joints
Deep tendon reflexes are hyper reflexive
Strength is weak/strong

A positive spatula test is associated with tetanus. The face tightening, jaw tension & odd smile are also symptoms. Tetanus is caused by a toxin produced by a bacteria, so I would use the ICD code 787.

The symptoms don't entirely fit with rabies, and Hawaii is considered to be rabies-free. I'm not clear if he was geocaching in Hawaii or if the trip was just mentioned in passing.

The other ICD codes don't fit the symptoms at all.

Did they give you lab results? CBC and chemistry values are used to find the north & west co-ordinates.

Good luck with the puzzle!

 

[SplshMtn99]

Did they give you lab results? CBC and chemistry values are used to find the north & west co-ordinates.

Good luck with the puzzle!

Here's the lab results but I've been googling & can't find what each "field" stands for. Like which is Bun? Which is Creatinine? And so forth.

http://img.geocaching.com/cache/d5ab2333-4170-42c9-a682-b31be2f93326.jpg

 

[ZipaDeeDooDah]

My first thought is tetanus too.

What was the answer to the other case???

 

[ZipaDeeDooDah]

In your first post you mentioned the clue that "he got a splinter in his thumb while searching for a geocache"

Splinters in the thumb could produce tetanus.

 

[christiane]

Try these for the lab results:

They are the best fit for what is normal. The first diagram is the CBC (WBC, Hgb, Hct, Plat). The second diagram is part of serum chemistry (Na, K, Cl, C02, BUN, Creat, Glu).

Hope it helps ...

 

[happywanderer2]

I would guess tetanus-but the icd-9 code for tetanus is 037, not 787, which is the head code for a list of symptoms involving the digestive system--of course, being a coder I know the drs.don't code very well

And the code of 491 is chronic bronchitis. The real code for muscle cramps is 729.82, if you are only coding symptoms. It could be dehydration, but the code for that is 276.51, not 491.

Maybe they just gave bogus codes to further protect this pt's privacy?

Anyway, my vote is for tetanus.

 

[SplshMtn99]

My first thought is tetanus too.

What was the answer to the other case???

lyme
but the answers to the puzzles really aren't the diagnosis, its the solution of working out the coordinates by doing the required math.

So when someone just tells me the diagnosis, it doesn't really help me. lol

 

[SplshMtn99]

Try these for the lab results:

Hope it helps ...

SOLVED!!!! That's what I needed to get the solution & its been confirmed. THANKS again. You rock!!!!

I'm going back to delete any info now.

 

[ZipaDeeDooDah]

Sorry, I misunderstood. I work in the medical field, so I jump to conclusions when I hear the symptoms.

Did you win???