qbee tisesd Wha ae Live Ware get ite da det Cireutas A-37 pectin : -- -—- ° ; Report on _ or CLINICAL RECORD . . _—_ (Specify type of examination or data) Zaze (Sign and date) PRIVACY ACT MATERIAL REMOVED hydrogen bonb testing during 1954. aday. eet Oa yereey Continuation of S. F. Final _Siosary,_Novenber_2) 21919) (Steske outaone line) social drinking. se mwtmt re et Re Cre CF a Patient stated he did not drink, occasional He was on DBI 50 milligrams tyrico a day, Benemid four times Family history was not remarkable. and lumbosacral strain. In 1951, he had spinal meningitis In 195), radiation sickness, diabetes mellitus and hypo- thyroidism and gout since 1963. adonoidoctomy in the 1950's. Ho had an appendectomy and tonsillectomy and The reviow of systcns was essentially as presented in tho history of present iljmess. On physical examination, he was a well-dovelope moderately obese’ malo in no acute distress, alort, conscious, coherent and inteldigent. Blood pressura was 140/100 right arm rocunbent position, pulse 63 and regular, respirations 20 per minute and regular. Head, eyes, ears, nose and throat exemination revealed prominent conjumctivae, sclerae clear, pupils reactive to light and accommodation, fundi revealed Grade I to II changes and they also’ had small multiple exudates, bilateral, more on the left side. Uvula and soft ~~ palate midline. Tongue well papulated and midline.” Necit - JVP nowt distended; ~ carotids equal,’ no bruits; no lymph nodes palpable; thyroid barely palpatie. ‘he chest was clear to percussion and auscultation. Heart revealed PMI impossible to find socondary to massive’ obesity. Heart rate 88 per minute. Heart sounds quitenormal; no murmur; no gallop. Abdominal wall was fairly obese, bowel sounds pro- ~ sent, non-tender, non-rigid; no hepatosplenomegaly. Rectal normal, ‘bogcy prostata and a’ few external skin tags. Peripheral blood systems normal, peripheral vessels palpable. Skeletal system normal. Neurological examination revealed left lc er extremity small deficit of sensory and position sense on the left. Motor sys-a intact. Cranial nerves normal. Cerebral system normal. Gait and speech normal. Reflexes withinnormal limits. Examination of the skin reveals a few multiple freckles and nevi over the back, over the front and around the neck. ‘he various’ investigations done while he was in the hospital showed the urinalysis - color yellow clear, reaction 6.0,-specific gravity 1.013; albunin, sugar, acetone nezative, occasional red blood cell, rare white blood cells. ‘Culture and sensitivity was essentially negative. Later on, the urine examination revealed 10 to 12 White blood cells por high field. Urine culture and sensitivity revealed colony count’ moro than 15,000 colonies, prodominantly Stroptococci, not onterococci. Whito —~ blood cell count was 9,200, hematocrit 48%, hemoglobin 15.2, red blood colls 6.9. Roticulocyte comt in the beginning was 5.3, later it fell to 4.2%. PBI was 4.2e Uric acid - initially, it was 8.5, later’ on in treatment with ALlopurinol and Beremid fell down to 5.2. VDRL was non-reactive. Urine examination, Clinitest, revealed sugar 3 positive. WSC stone differential showed neutrophiles 56, bands 2, lymphocytes 37, monocytes 3, eosinophiles, platelets 204,000. Electrolytes: COs 24, chlorides 98, sodium 142, potassium 4.7, calcium 9.7, phosphorus 3.7 and uric -acid 8.5. Cholesterol 269, urea nitrogen 13, creatinine 1.0, alkaline phosphatase ' (Continue on reverse side) PATIENT S&S IDENTIFICATION (For typed or written entries five. Narme—iant, Arat, middie; grade; date, hospitalor medical lacstity) aha } REPORT ON ~ ° WA Hospital, Houston, Texas rng 11-27-1970 DOE ARCHIVES WARD NO REGISTER po. er CONTINUATION OF . Alundard Form A0T 307-104 _PRIVACYACTMATERIAL REMOVED ” 108