General medicine case 2

 12th Oct 

A 70year old male resident of ghanakonda came in to casualty with chief complaints of Altered sensorium since 4am in the morning.patient was normal till 6pm in the night,then had dinner and felt uneasiness and took tab.GLIMI M2at around 7pm and had altered sensorium at around 8pm,then went to local hospital and found he was in hypoglycemia,then discharged at around 10pm.at 3:30am in the morning,patient attenders saw that patient was making gurgling sound and brought to KIMS for further evaluation.


PAST HISTORY:
K/c/o hypertension (on tab.TELMA met xl 40/50)po/od
K/c/o DMT2(On T.GLIMI ME /PO/OD)


Not a k/c/o  CAD, asthma, TB, epilepsy.


PERSONAL HISTORY:
Patient has mixed diet with normal appetite and adequate sleep. 
he has normal bowel movements and bladder filling. 
No addictions. 

No significant family history or allergic history. 

GENERAL EXAMNATION:

No pallor, icterus, cyanosis, clubbing, lymphadenopathy, pedal edema. 
VITALS:
BP: 100/60 MMHG, 
PR: 100bpm 
Temp: 98.2°F, 
SPO2: 95% 
RS: BAE+,NVBS,B/L IAA Crepts.
CVS: S1 ans S2 heard. No murmurs. 
CNS: Patient is alert,speech -aphasic,no meningeal signs.all reflexes  present.

INVESTIGATIONS: 
 1. Haemogram 


 2)CUE
Alb:nill
Sug:nill
Ec:3-4Pc:2-3
RBC:nill

3)USG-
Raised echogenicity of both kidneys corelate with rft


4)serum electrolytes




Comments

Post a Comment

Popular posts from this blog

Prefinals answers

Image
2. Define cirrhosis of liver. Etiopathogenesis of cirrhosis. Write a brief note of clinical features, diagnosis and treatmentof cirrhosis of liver. 4. Etiology of pleural effusion. Diagnostic criteria of pleural effusion.  5. Diagnosis and treatment of Dengue fever.  6. Clinical features and diagnosis Peptic ulcer disease.  9. Etiology and treatment of pneumonia.  10. Complications of dialysis  11. Ascitic fluid analysis.  14. Treatment of urinary tract infection. 15.Differential diagnosis of fever with rash . 16.Insulin therapy in diabetes mellitus.  17.Antihypertensive drugs in chronic Renal failure.  18. Types of intracranial hemorrhage.
Read more

General medicine case 8

Image
  54 yrs old male patient with acute kidney injury secondary to left lower limb cellulitis December 05, 2021 54 years old male patient came with chief complaints of shortness of breath and left lower limb swelling since 5 days . H/o present illness:- Patient was apparently asymptomatic 5 days back and then he had a injury to his left leg followed by itching of leg and developed left lower limb swelling associated with shortness of breath ( grade II- III) according to NYHA  classification. No history of chest pain/palpitations. No history of chronic cough/hemoptysis In 2016 patient went to hospital  due to pedal edema where patient had ischemic encephalopathy followed by 4 sessions of dialysis was done and discharged not as any medications after that. Past history:- Patient is not a k/c/o Dm, asthma, epilepsy hypertension. Personal history: Diet-mixed  Appetite-decreased Bowel and bladder movements-regular Daily alcohol consumer 5 years back,stopped 5 years back and recently he had 100
Read more

General medicine case

Image
  This is an online elog book to discuss our patients de-identified health data shared after taking his /her/ guardian informed consent here we discuss our individual patients problems through series of input from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs. Date of admission: 21 October 2021 A 60 yr old male who is a farmer by occupation came to the OPD for the dialysis diagnosed as kidney failure 1 1/2 back . He went to local hospital and was diagnosed with renal failure( serum creatinine 3mg/dl) Chief complaint: patient complains of shortness of breath, sleeplessness, swelling of limbs. HISTORY OF PRESENT ILLNESS : •Pedal edema  • Anorexia  • Fever  • Dyspepsia  •  Insomnia  • Serum creatinine levels - increased (2 mg /dl)  • Decreased urine output  Presently on dialysis on MHD  HISTORY OF PAST ILLNESS :  On dialysis since 1 and half year  K/h/o Hypertension sice 6 years  No h/o
Read more