Without a proper history.

My patient’s disease may remain a myster,

But even with all this info,

Sometimes labs and physical are the way to go.

For ischemic heart disease, I might look for hyperlipidemia,

Course if her hemoglobin’s eight, she’s got pretty bad anemia.

If I’m scared you’ve got pneumonia, I’ll check your sputum with a gram stain,

I’d do a similar test of your CSF to find an infection around your brain.

When I tap the kid on the forehead, if it hurts he’s got sinusitis,

But with a bulging immobile TM, the kid most likely had otitis (media).

To CYA with an asthma kid, it is imperative to do an ABG,

If it is allergies I suspect, I should run a serum IgE.

For me to confirm Herpes I’ve got to do a Tzanck smear,

If I’m afraid the guy’s got gonorrhea – I must swab the place he holds so dear.

Doing a pelvic on a woman with PID will likely cause her to hit the chandelier,

And to rule out HPV, you must get a Pap smear (every year).

When she has a suspected UTI, I’ll find nitrates and LE with a urine dipstick,

If it has worsened to pyelonephritis, I’ll treat her with IV antibiotics…real quick.

A patient doubled over in pain screams nephrolithiasis,

And I always check BUN/Creatinine because renal insufficiency is something I don’t wanna miss.

Twenty-four-hour pH monitoring can confirm my patient’s GERD diagnosis,

While fat, forty, female, and fertile suggest cholelithiasis.

For heme-postitive stools, a nasty peptic ulcer may be the answer,

but I better ‘scope him fast so I may rule out colon cancer.

Rheumatoid Arthritis has characteristic X-ray findings including a pannus,

But anti-nuclear antibodies in the serum direct me more towards lupus.

Exophthalmos is a characteristic finding in hyperthyroid,

And you better treat it fast cuz that’s a look you wanna avoid.

High urine catecholamines suggest a pheochromocytoma,

A diabetic foot’s must easier, often you can tell by the aroma.

For gout I’m thinking history first, but I can look for elevated urate,

And then there’s the famous prostrate, and we all know the exam and it ain’t that great!