ERIN BRADLEY (ENDOCRINE) CC; NAUSEA AND VOMITING, FEELING SHAKY AND HOT ALONG WITH
A FLUTTER IN CHEST
In this case study of E.B. 21 year old female her chief complaint is Nausea and vomiting, feeling
shaky, hot, and fluttering in her chest. When asked she stated she was recently in the emergency
room for these symptoms.
1. Are there other symptoms related to your complaint? Yes, chest fluttering, chronic
cough, and menstrual period are changing.
2. Do you have pain? NO
3. Do you have fatigue? Yes I am exhausted walking up the stairs
4. Have you been having fevers? Yes I was sick about a week ago with the flu.
5. Have you been losing weight? Yes I eat like crazy, but keep losing weight.
6. Do you have night sweats? No
7. How much weight have you lost? 10 lbs.
8. Have you had change in bowel habits? Yes I used to be constipated , now I go all the
time 3-4 times daily.
9. Do you have a cough and are you coughing up anything? Yes it started a week ago when
I was sick, and now I am starting to cough up sputum.
10. Are you short of breath? Just when I exercise
11. Do you have a headache? No
12. Are you having problems with your periods? Lighter flow and skipped periods, states she
is not pregnant.
13. What does the sensation in your chest feel like? Like its skipping a beat, started a
couple weeks ago, mainly when I walked fast but now it’s all the time.
14. Do you have a sore throat or rash? No to both
15. Do you have any past medical history or allergies? No to both
16. Do you take any medications? Only calcium tablets and Claritin, Tylenol as needed.
17. Are your immunizations current? All except the flu shot.
18. Any surgical history? Wisdom teeth at 18 yrs old.
19. Do you drink alcohol? Yes at parties but not now.
20. Do smoke or do drugs? No to both
21. Are you sexually active? Yes
Important components of the physical exam are the patient observed to be sweaty all over,
hair growth on eyebrow are thin, thyroid measures 65gms, has a ropy feeling isthmus, and
thrills and bruits are heard bilaterally. The patient is noted to have a fine tremor and bad
handwriting, she is tachycardic, and crackles are heard in her lungs. Patient denies dizziness,
night sweats, drug use, rashes, pain, or difficulty swallowing.
This patient is exhibiting symptoms of possible pneumonia/sepsis and Thyroid Storm. She
raises suspicion for pneumonia due to her recent cold x 1 week ago with lingering cough,
fever, crackles in her lungs and shortness of breath upon exertion. She is also showing
multiple symptoms of a hyperthyroidism and thyroid storm. During a thyroid storm a
patient’s heart rate, blood pressure, and body temperature can rise to high levels. In
hyperthyroidism your body is producing too much T3 and T4 which control metabolism,
A FLUTTER IN CHEST
In this case study of E.B. 21 year old female her chief complaint is Nausea and vomiting, feeling
shaky, hot, and fluttering in her chest. When asked she stated she was recently in the emergency
room for these symptoms.
1. Are there other symptoms related to your complaint? Yes, chest fluttering, chronic
cough, and menstrual period are changing.
2. Do you have pain? NO
3. Do you have fatigue? Yes I am exhausted walking up the stairs
4. Have you been having fevers? Yes I was sick about a week ago with the flu.
5. Have you been losing weight? Yes I eat like crazy, but keep losing weight.
6. Do you have night sweats? No
7. How much weight have you lost? 10 lbs.
8. Have you had change in bowel habits? Yes I used to be constipated , now I go all the
time 3-4 times daily.
9. Do you have a cough and are you coughing up anything? Yes it started a week ago when
I was sick, and now I am starting to cough up sputum.
10. Are you short of breath? Just when I exercise
11. Do you have a headache? No
12. Are you having problems with your periods? Lighter flow and skipped periods, states she
is not pregnant.
13. What does the sensation in your chest feel like? Like its skipping a beat, started a
couple weeks ago, mainly when I walked fast but now it’s all the time.
14. Do you have a sore throat or rash? No to both
15. Do you have any past medical history or allergies? No to both
16. Do you take any medications? Only calcium tablets and Claritin, Tylenol as needed.
17. Are your immunizations current? All except the flu shot.
18. Any surgical history? Wisdom teeth at 18 yrs old.
19. Do you drink alcohol? Yes at parties but not now.
20. Do smoke or do drugs? No to both
21. Are you sexually active? Yes
Important components of the physical exam are the patient observed to be sweaty all over,
hair growth on eyebrow are thin, thyroid measures 65gms, has a ropy feeling isthmus, and
thrills and bruits are heard bilaterally. The patient is noted to have a fine tremor and bad
handwriting, she is tachycardic, and crackles are heard in her lungs. Patient denies dizziness,
night sweats, drug use, rashes, pain, or difficulty swallowing.
This patient is exhibiting symptoms of possible pneumonia/sepsis and Thyroid Storm. She
raises suspicion for pneumonia due to her recent cold x 1 week ago with lingering cough,
fever, crackles in her lungs and shortness of breath upon exertion. She is also showing
multiple symptoms of a hyperthyroidism and thyroid storm. During a thyroid storm a
patient’s heart rate, blood pressure, and body temperature can rise to high levels. In
hyperthyroidism your body is producing too much T3 and T4 which control metabolism,
