The Money Tests


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!

Christopher Coury, Class of 1999