Male, 40 y o. comes to the office. First scheduled the appointment for a nasty cold\" which has since seemed to be resolving, but he kept the appointment anyway. He complains (aside from resolving cold sxs) of occasional headaches sometimes quite bad. He uses Motrin (600mgs) maybe 4 timesweek for these. He also has episodes of profuse sweating and anxiety, accompanied by pounding heart. He doesn\'t like the suggestion these are \"panic attacks he says his mom had those \"she was a real basket case- we didn\'t get on on very wel\" Mom is deceased age 65. dlt stroke) occasionally he gets dizzy on standing rapidly. Sometimes constipation is a problem. Symptoms have been present as an adult-- more with age, had been attributed to stress at work, but wants another opinion. His work ls described as \"stressful\" around the end of the quarter (he\'s an accountant) but not all that bad\" between-times. He works out (running and weights) 4week. Describes himself as pretty fit, and basically looks it, sleeps 5-8 hours/night. Sometimes better than others. No prescription drugs. Has \"a couple beer on the weekend, marijuana 1-2/year, denies other drug use. Says he avoids coffee, especially espresso \"makes me too jittery\" Physical: Ht, 6\'0 wt. 160 BP 136 90 HR 74 Resp 20 Reflexes (patellar, achilles) strong. A slight tremor appears present in the arms when held out and still. No abdominal or neck masses on palpation. no abdominal tenderness. Heart sounds are normal, rythm regular, no murmur. Lungs- some wheeze on forced exhalation; al lobes seem clear, CBC shows Inc. RBCs, normal morphology and hemoglobin Normal WBC count, but with lymphocytosis Platelets unremarkable TSH is normal Blood calcium is elevated. Blood glucose is slightly elevated UA shows a trace of glucose in the urine Solution Cannabis sativa also called as Indian hemp or marijuana. The plant has resin called cannobinol it is inert, on exposed to heat converted to active isomeric tetrahydrocannabinol. It is CNS stimulant. The leaves and fruits , we used as tea to prepare a decoction. The symptoms of intoxication are, Feeling detachment, euphoria, rapidly changing emotions Feeling of distress and tightness in the chest He also has increased appetite, nausea, pressure in the head, ataxia, restlessness, tachycardia, urinary frequency. In chronic poisoning degeneration of CNS occur, weakness, tremors, red eyes, impotence and he may develop psychosis. Hence clinical diagnosis is marijuana poisoning. Treatment includes 100ml of 50%glucose, 2mg . Naloxone and 100mg thiamine I.v. 5to10 mg. Of diazepam used, if the aggressive patient. If flashback occurs, give anti-anxiety and antipsychotic drugs. Psychotherapy is also given. It is not conserned with adrinal gland or tumour..

1. Male, 40 y o. comes to the office. First scheduled the appointment for a nasty cold" which has
since seemed to be resolving, but he kept the appointment anyway. He complains (aside from
resolving cold sxs) of occasional headaches sometimes quite bad. He uses Motrin (600mgs)
maybe 4 timesweek for these. He also has episodes of profuse sweating and anxiety,
accompanied by pounding heart. He doesn't like the suggestion these are "panic attacks he says
his mom had those "she was a real basket case- we didn't get on on very wel" Mom is deceased
age 65. dlt stroke) occasionally he gets dizzy on standing rapidly. Sometimes constipation is a
problem. Symptoms have been present as an adult-- more with age, had been attributed to stress
at work, but wants another opinion. His work ls described as "stressful" around the end of the
quarter (he's an accountant) but not all that bad" between-times. He works out (running and
weights) 4week. Describes himself as pretty fit, and basically looks it, sleeps 5-8 hours/night.
Sometimes better than others. No prescription drugs. Has "a couple beer on the weekend,
marijuana 1-2/year, denies other drug use. Says he avoids coffee, especially espresso "makes me
too jittery" Physical: Ht, 6'0 wt. 160 BP 136 90 HR 74 Resp 20 Reflexes (patellar, achilles)
strong. A slight tremor appears present in the arms when held out and still. No abdominal or
neck masses on palpation. no abdominal tenderness. Heart sounds are normal, rythm regular, no
murmur. Lungs- some wheeze on forced exhalation; al lobes seem clear, CBC shows Inc. RBCs,
normal morphology and hemoglobin Normal WBC count, but with lymphocytosis Platelets
unremarkable TSH is normal Blood calcium is elevated. Blood glucose is slightly elevated UA
shows a trace of glucose in the urine
Solution
Cannabis sativa also called as Indian hemp or marijuana. The plant has resin called cannobinol
it is inert, on exposed to heat converted to active isomeric tetrahydrocannabinol. It is CNS
stimulant. The leaves and fruits , we used as tea to prepare a decoction. The symptoms of
intoxication are, Feeling detachment, euphoria, rapidly changing emotions Feeling of distress
and tightness in the chest He also has increased appetite, nausea, pressure in the head, ataxia,
restlessness, tachycardia, urinary frequency. In chronic poisoning degeneration of CNS occur,
weakness, tremors, red eyes, impotence and he may develop psychosis. Hence clinical
diagnosis is marijuana poisoning. Treatment includes 100ml of 50%glucose, 2mg . Naloxone and
100mg thiamine I.v. 5to10 mg. Of diazepam used, if the aggressive patient. If flashback occurs,
give anti-anxiety and antipsychotic drugs. Psychotherapy is also given. It is not conserned with
adrinal gland or tumour.