Document 4JrXBGwL8QGa3mjxb8p0xLx7G

TENTATIVE OUTLINE SUBMITTED' POE SUGGESTION, CRITICISM AND APPROVAL OE THIS STUDY ' PURPOSE OE THE INVESTIGATION I. To.ascertain which one of the various laboratory procedures used at present for detection of lead in a patient with signs and symptoms compatible with a lead intoxication, will prove or disprove the etiology* a. To determine which one of the various chemical tests is accurate* '* , b* To determine the diagnostic significance of baso philic stippling. c* To determine the accuracy of the spectrographic technic* ANAMNESIS AND PHYSICAL EXAMINATION TO BE OBTAINED FRO# CASES OP PLUMBlS , SAME AGE RACE OCCUPATION 1* type of worlc . 2* duration REEERRED DIAGNOSIS DURATION . HISTORY 1 Chief Complaint 2. Present Illness 3* Past History a* previous diseases b. general health - c. weight - loss or gain d injuries or operations e* head -- headaches, insomnia, dizziness, confusion* convulsions, coma, irritability, cooperation f, eyes -- glasses, failing vision, diplopia, dimness* , squint, spots before eyes. g* ears -- loss of hearing, pain, discharge, tinnitus* buzzing, h, nose -- head colds, discharge, epistaxis, obstruct ion, odors* I, oral cavity -- a* Tongue -- coated, fissures, burning, ulcers b, teeth -- caries, alveolar absorption, fill ings, gum retraction* c throat -- tonsillitis, sore throat, metallic taste, sweet taste, aphthous ulcer herpes* J* Cardio-Respiratory -- palpation, synocope, pain in heart-character, dyspnea, edema, cough, sputum, hemoptysis, chills, fever, pallor, weakness* K* Gastro-Intestinal -- anorexia, constipation, dia rrhea, nausea, vomiting, abdominal colic, rigid abdomen, hematemsis, jaundice, stools tarry or clay colored* .) L. (Jenito-TJrinary -- polyuria, nocturia, dysuria, hema turia, pyurea, retention, incontinence, venereal* M. Heuro-Muscular -- tremor, fibrillary twitchings, neuritis - any type, paralysis, muscle sore ness, fatigue, joint pains, weakness, numb ness, restive, moody, easily excited, flus tered, sharp shooting muscle or joint pains tingling, girdle sensations, disposition* N. Catamenia 0* Marital History - children, abortions, miscarriages F* Habits - alcohol, drugs, tobacco Q* ffamily History* 0001447 PHYSICAL EXAMINATIONS 1 Head a. Scalp - . b. hair c. face - pallor, premature aging, general appearance* d. eyes ~ complete History, fundus examination* e. ears --complete history, hearing tests. f. nose -- examination, tests for smell. g. mouth -- teeth, gums-metallic line, retraction, tongue pharynx, larynx-character of voice* 2. Hebfc a. pulsations b. stiffness c. thyroid 3. Thorax - type, abnormal pulsations a. heart -- apex impulse, position, sounds, rhythm, mur murs, blood pressure-right arm, left arm, pulse-character, rate, EKG. b. lungs.-- respiration, depth, character, rate, X-Ray, 4. Abdomen a. Liver b. Spleen c. Kidney 5. Genitalia 6. Extremities - complete neurological examination. 7. Skin - history, description of any lesions. 8. Bones - tenderness, Roentgenograms, diaphyses of long bone if a child* ^ 0001448 / LABORATORY DATA 1* Urine a. Routine examination - porphyrins b. Method of collecting and number of specimens to be submitted. c. Methods to be used on a given specimen, quantity of urine necessary and the submission of.an outline '# of the technic employed. - 2. Feces a. Routine examination - b. Method of collecting and number of specimens to be submitted. c. Methods to be used on a given specimen, quantity of feces necessary and the submission of an outline ' of the technic employed. 3. Spinal Fluid. a. Routine examination b. Method of collecting and number of specimens to be submitted. c. Methods to be used on a given specimen, quantity of fluid necessary and submission of an outline of the technic employed. 4. Blood a. Routine examination (l) number of each basophilic count and technic employed. b. Method of collecting and number of specimens to be submitted. c. Methods to be used on a given specimen, quantity of blood necessary and submission of an outline of the technic employed. 5. Tissue Analysis " a. Method of obtaining specimen. b. Biopsies necessary and cutaneous site c. Submission of outline of the spectrographic technic. CORRELATION OF THE CLINICAL AND LABORATORY DATA TO DETERMINE WHICH LAB ORATORY PROCEDURE SHOULD BE RECOMMENDED TO THE PHYSICIAN FOR DIAGNOSTICO . PURPOSES-Iff SUSPECTED CASES OF PLUMBlSM.