Kiah ellis foxtrot 382526 blood test from the 07/21/2025 using his normal crp 5 routine albumin raised albumin 58 bilirubin 77 alt 26 full blood count normal blood cultures negative venous blood gas mild alkalosis only further investigations are awaited including ultrasound abdomen and noninvasive liver screening past medical history pitten well no allergies no regular medications social history care lever complex social background no local support alright madid can you go so we've had your scan yet yeah you've it before there's no report yet but I'll write the report to you like I say I'm doctor minaj I'm with the liver gastroenterology and the medical doctors tell me all about it what's been happening so I've got eating just feeling full like not starving myself like but literally feeling full so I haven't eaten and then I've realized oh yesterday I ate a pop noodle all day all day all day pop noodle and I walked here no no roughly from here and back because I went on a walk because yes I shouldn't have but I couldn't stay in my room I paid the price for it in the morning because I felt like shit I've gone from abdominal pain to tightness in my and when I stand up it damages palpitations the sensation of your heart beating yeah but I don't know if that's normal because obviously if you're moving around your heartbeat is supposed to go up and down a minute so I don't know whether that's normal or not and the tummy pain whereabouts is that it got the left side it's over there it was just a little stab but then all of a sudden it was like moved around the whole time I had 1 of those you know those weight belt things you see on gym people it's like I've got 1 of them still attached to me all the time someone's literally around your chest yeah like that like I've a rubber band around my finger and it's just cutting off the yeah no it's fine don't worry I I don't know how to explain it because it's it sometimes hurts sometimes I can ignore it k I literally don't know what to do yeah there's nothing that makes it worse or better does eating make it worse yeah is that why you're so I'm feeling full like had so that popped noodle I had a bite I felt full like it wasn't like well not even that I wasn't really hungry just okay fine and when you ate did it make your pain worse or you just I just felt full just felt very very very uncomfortable yeah it's like when you're literally you like have a sunshine and it's the last just so you're wasting it but that's the first 1 and that was the first 1 so it makes no sense and any other symptoms are you having some fevers I hear yeah so as you can see there's this I'm sweating I haven't walked just been sat in the way too I've quite literally just been sat there right I stood up I felt dizzy so you know that scab excuse me yeah so I sat down I stood up and that's when I noticed my heart was racing again I was like okay I'll bring it up this time because about the irregularly irregular heartbeat right so I was having 2 and then 4 mhmm so yeah I don't know okay I have the sheets still in my room oh the ecgs that you had ecgs because I didn't want this wrong they've they they weren't freaking out about them they were confused by it too this is the ambulance crew is it yeah yeah that was the entire reason I got brought in so what was I we were talking about fevers ah that's another thing I'm forgetting things quite often it'll be mid conversation like I'll have a. With someone and say for example you're like oh yeah yeah let me tell you something and I'm like yeah yeah go on I don't know where that's come from yeah strange and how long have you been how long have you been feeling feverish for feverish is roughly the same as the abdominal pain but the memory thing is is being likely before that okay and how long is the abdominal pain how long has all this been going on for the abdominal pain has been not originally the was about 3 because last time what happened is I had a rugby accident and a really fat kid fucking landed on that side and I was like really hurting body when got it checked out it was this side that side got checked out they were like this side so I was like okay yeah have you had anything any other injuries lately no so they and bruising as well you've noticed increased bruising yeah like I'm not knocking my legs you but know it's there on your bruises there are a few bruises on your calves and your are they tender to press no no they're not tender they're just dark marks they're just bruises and any soreness in your muscles and muscle aches shoulders shoulders any sore throat scratchy scratchy throat like I can't eat like sandwiches and stuff like that's why I drink yeah a tea fine and anyone else still that you know you live with living by myself you live by yourself fine okay and tell me about your life more generally do you work no no work mhmm I'm in temporary accommodation at the moment okay and yeah that's basically but it's it's when I'm going up it's like when I'm getting ready to do stuff I won't get have the energy for it even though I haven't done anything all day mhmm that makes no sense any swimming lately or any contact with any dirty water no no been traveling anywhere recently I've traveled back up to wales but that's it fine and where about some wales abercane okay cardiff yeah fine close to cardiff yeah fine so south wales yeah yeah fine okay and in terms of the tummy pain now then moving to the chest pain yeah know yeah I picked it because it's quite funny yeah I don't know who put the label on but it's required label label maker nice very good yeah yeah the chest pain you said you're having palpitations palpitations and chest tightness along with the tummy pain you know how you just don't usually notice your heartbeat yeah of course for some reason I'm noticing it a lot more than you like I'll just be sat here and then all of a sudden it'll be boom boom boom boom and I'm like okay can you go away now because I'm not doing anything okay yeah it's not just when I stand up like I could be just laying there just when you have a fever yeah it could just be laying there and it's not the fever I I eat sweats stopped smoking weed then roughly stopped okay so not at the same time month they were gone mhmm but night sweats that's another thing and you and that's over the last few weeks or week 5 days or so as well that that was the past month because months low okay because it was fucking drenched excuse my language I know it's fine no don't worry it's fine it was drenched and I I actually I was like there's no way I fucking missed a bed yeah yeah so I was like on your legs fucked up no I was like big bump yeah no my face is sweating my back's sweating mhmm doesn't smell like a bed I'm sweating any lumps or bumps anywhere that you've noticed no no fine any pain in your you said your shoulders hurt but do your bones hurt like your feet and your hips things like that no no any weight loss how much weight you lost can't exactly say because like I didn't know the exact weight at the time of my fes because when you're that big you just don't want weight I read some letters from the pediatric department I think I saw them a while ago look that's the amount of weight I've lost okay so over how long this well this picture was taken may 12 okay so in a year yeah mhmm okay alright and k okay can I have a quick look do you mind if you just watch my hands no they're gonna be great because I don't have to tell me if that's okay yeah thank you I should probably get a shit when I try and concentrate on my hands too and you said you smoked weed before any other nasty drugs or anything like that tell me about that tried ket a couple times didn't like it done never touched it again mhmm no literally like 2 or 3 times 2 or 3 times it was like okay in a party it was so there was twice in 1 party and then there was once in on someone's birthday never done it tried coke once and never tried it again okay fine and then drinking obviously I was drinking on again but like sweating yeah like I think we just did so $4 to your back thank you alright so are you ready so give him his breath his legs this way a little bit mhmm like that good and shall I look at your tongue so now you look at your tongue thank you it's a bit tender there leo there there there it's got patchy on the tummy before no if I press here and you take a big deep breath in is that pain not painful but a bit sore how about your legs any pain or shortness of breath that one's new that 1 wasn't there on the ultrasound scale mhmm yeah that 1 was in there again that 1 was in there yeah we'll have a look and see if you're scared about it thanks for that certainly to examine you there's nothing that I can see to worry about obviously lots of yellowness in the eyes yeah and did you notice that first yeah when how long have you had that before I noticed that after the abdominal pain started no 4 days ago or so the day after I had a shot pick so yeah I yeah they're not you mean alec they've done it great what are they saying no cause to the patient's symptoms unrockable appearance of the liver the gallbladder is thin walled minor biliary sludge graphically murphy's negative no duct to duct okay that's a shame was hoping to find something better so your jaundice levels in the blood are high and your levels of liver inflammation are slightly high but the remainder of your tests are quite reassuring there's no nasty bugs growing in your blood the markers of infection are quite low your kidneys are doing fine and you're full blood I've asked them to repeat these tests today as well as do a big panel to look for viruses I suspect you have infectious mononucleosis or kissing disease or glandular fever they're all the same thing I suspect you have a viral infection causing this jaundice level the sweat you're having and the tummy pain when the liver is irritated the liver stretches all the way across the upper tummy and when the capsule becomes irritated it can cause abdominal pain which we're experiencing and it may feel genuinely crap could be bruises etcetera just sweating makes no sense to you because obviously over the amount of water around and drinking and stuff yeah but when you're hot and feverish then you can definitely have sweats we haven't taken your observations yet but when you were there on the 20 first that was me didn't have any- 20 40 or something yeah yeah fair so at the moment your heart rate is not too bad 90 I would say just from eyeballing it can I see you had some observations then think so okay oh you were 37.3 so you had a low grade fever when you were in a and e on the 20 first so you I suspect you as I said you have a viral infection causing things I've asked to do a big panel of viral tests not many of them will come back today drinking water's fine yeah yeah drinking water's good yeah I love drinking water nice I didn't know if had to drink a lot of drinks because I was a hot drink helped inside maybe yeah but water's fine I think lots of water is good I suggest we'll get some more blood tests today check these liver tests if the liver tests are improving or about the same then that's great if the liver tests are getting much worse and your bilirubin is over a 100 I'd be a bit more worried and I might be suggesting keeping you in hospital to keep an eye on them but hopefully that won't be the case and they'll be getting better and then I'll do a big screen for all loads of viruses and we can see what they come back you should come back because your blood tests are very wary okay do know what I mean yeah no I've actually got a bus pass because obviously I said about the leaving the bed thing yeah course so I spoke to my lot for the ability to get around today so know I would suggest staying to wait for the blood test to save a wasted journey there and back by the time you've done an hour you probably will have waited for the bus and got home it's always frustrating if I call you and I come back I'd rather have like done a little walk around before you just torture because the thing is I'm sweating sitting down yeah of course + the heat yeah no feel free to have a walk around I don't feel bad with the people because I don't wanna smell like beetle because that's awful no no don't worry you don't smell so you'll be fine and I'll I'll call you and get make sure you get the blood test done and I'll ask them to take them from you and then once the blood test come back I can give you a call and we can chat about it how who what am gonna know so I'll take you to the triage room they'll take your blood and then you can go for a walk I'll call you when the pillows come back sounds sound okay yeah great any questions that you have gotten 0 good thanks no no contact good he's got a great headache from the presentation oh really I'm so sorry okay you very much no don't worry thanks for having us hello nice alright yeah I've got brought a customer for you for some bloods is that alright or is it the main yeah he's yeah he's on the system alright is that okay I know I've sprung him on trick question in 1 of my interviews actually is that okay comes along and asks you to take those without an aim all no no it's it's all on the computer alright thank you very much see you soon so impression is most likely ebv leading to jaundice and fevers plan number 1 blood tests including acute hepatitis screen number 2 if lfts improving or static then could go home to have repeat lfts again on friday number 3 if lfts worsening then consider admission under hepatology number 4 paracetamol for fever and then investigations ultrasound abdomen unremarkable appearance of the liver gallbladder thin wall containing minor biliary sludge patient sonographically murphy's negative no intra intrahepatic ductal dilatation unremarkable appearance of the pancreas kidneys and spleen urinary bowel small volume of urine unremarkable no cause for patient symptoms identified on this study