38 year old male is found down in his home by neighbors. An ambulance is called and he is breathing very shallowly and can barely speak, they quickly intubate the patient and place on a mobile ventilator and take him to the ER. There he is examined by the ER PA on duty who is you and you find that he is a well-nourished but unkempt Caucasian male who appears age appropriate. He cannot answer questions as he is intubated and unconscious due to versed. His lungs sound clear his pupils are equally reactive to light and accomodation and his neurological exam reveals generalized muscle weakness but seems to move all extremities but not very much. His heart sounds are normal. Abdomen is nontender and not distended. You order labs and chest x-ray and they are all normal range. Suddenly, he has a niece and nephew who come to the ER to find their uncle. They were the emergency contacts he had in his file from where he had an appendectomy a number of years ago. They are present now in the room and you can ask them three questions which they will answer. What do you want to know that will help you with this case? What is the mystery diagnosis?
38 year old male is found down in his home by neighbors. An ambulance is called and he is breathing very shallowly and can barely speak, they quickly intubate the patient and place on a mobile ventilator and take him to the ER. There he is examined by the ER PA on duty who is you and you find that he is a well-nourished but unkempt Caucasian male who appears age appropriate. He cannot answer questions as he is intubated and unconscious due to versed. His lungs sound clear his pupils are equally reactive to light and accomodation and his neurological exam reveals generalized muscle weakness but seems to move all extremities but not very much. His heart sounds are normal. Abdomen is nontender and not distended. You order labs and chest x-ray and they are all normal range. Suddenly, he has a niece and nephew who come to the ER to find their uncle. They were the emergency contacts he had in his file from where he had an appendectomy a number of years ago. They are present now in the room and you can ask them three questions which they will answer. What do you want to know that will help you with this case? What is the mystery diagnosis?
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