159 Ravali Irugurala

 General medicine

                                                            12/11/22

This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's  consent.

This E log book also reflects my patient-centered online learning portfolio and your valuable inputs in the comment box below.

Date of admission: 12/11/22

Case presentation:

Chief complaints:

40 year old female came to the casuality with complaints of fever since 1 week and pain in abdomen since one week 

HOPI:

Pt was apparently asymptomatic 1 week back then she developed fever which was continuous, low grade associated with chills and relives on medication. 

Pt has abdominal pain since 1 week which is  diffuse type

Decreased urine output since 3 days

Nausea,vomiting since 2 days 4-5 episodes/day, subsided now

Increased frequency of stools 4-5 episodes/day since 2 days which is greenish, small quantity, mucoid, non fouls smelling

Facial puffiness, pedal edema-pitting type, grade-3, abdominal distention since 2 days

No H/O burning micturition, cough, SOB, trauma.

Past history:

Similar complaints 1 month ago with burning micturition 

K/C/O Diabetes since 5 yrs 

on Medication

METFORMIN 500mg + T.GLIMIPERIDE 2mg + T.VOGLIBOSE 0.3 

N/K/C/O HTN,TB,epilepsy,CAD,CVA, asthma.

Hysterectomy done 10 years ago.


Drug History:

H/O usage of T.Naxdom 250mg 3 days ago given by RMP

H/O usage of antacids since 2 years for recurrent peptic ulcer disease 

Personal History:

Occupation:Housewife

Diet:mixed

Appetite: Decreased

Sleep: Decreased 

Bowel and bladder movements:

Decreased urine output and increased frequency of stools

No addictions

General examination:

Pt has no Pallor, icterus, cyanosis, clubbing, lymphadenopathy


Vitals on admission:

Pt is C/C/C

Temp:98.6F

PR:72bpm

BP:160/90mmhg

RR:18/min

SPO2:98%

Systemic Examination:

CVS:S1S2+

RS:BAE+

P/A:soft, tenderness right hypochondrium

CNS: No focal deficits 

Provisional Diagnosis: 

ACUTE KIDNEY INJURY (SECONDARY TO ACUTE GASTROENTERITIS)

FEVER UNDER EVALUATION

?DENOVO HYPERTENSION

OHA INDUCED HYPOGLYCEMIA .


INVESTIGATIONS:

Chest x ray:


Complete urine examination:


Liver function test:


Renal function test:


Blood grouping:


HBsAg-RAPID


Blood parasites:


Anti HCV antibodies -RAPID:


C- Reactive Protein:


DENGUE NS1antigen,IgG&IgM :



Urine protiein :


Serum electrolytes:


USG


ECG:


Stool examination:











Comments

Post a Comment

Popular posts from this blog

pre final OSCE Learning points

PRE FINAL OSCE LEARNING POINTS  05/12 /23  OSCE QUESTIONS :  1) Dialysis Disequilibrium syndrome?     Dialysis disequilibrium syndrome (DDS)   refers to an array of neurological           manifestations seen during or following   dialysis, primarily after the new initiation   of dialysis.However, it can also be seen in   chronic dialysis patients who miss their   regular dialysis treatments. This   syndrome is thought to arise from fluid   shifts during hemodialysis, causing   cerebral edema and a wide variety of   neurological symptoms. In continuous   renal replacement therapies (CRRT),   where fluid shift is limited, dialysis   disequilibrium syndrome is rarely     reported. The common risk factors that predispose a patient to dialysis dysequilibrium syndrome are  First hemodialysis treatment High blood urea nitrogen (BUN) (above 175 mg/dL or 60 mmol/L) before initiation of dialysis Extremes of age – children and elderly Sudden change in dialysis regimen Pre-existing neurological di
Read more

159 RAVALI IRUGURALA

Image
4-dec-2023 60 YEAR OLD MALE CKD ON MAINTENANCE HEMODIALYSIS WITH ANEMIA OF CHRONIC KIDNEY DISEASE WITH HYPERTENSION This is an a online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input A 60 year old male, who is a resident of Nalgonda ,farmer by occupation came with  Chief complaints : Pedal edema since 3 months. Shortness of breath since 20 days. Decreased urine output since 15 days. History of presenting illness: The patient was apparently asymptomatic 3 months back when he noticed bilateral pedal edema initially extending to ankle Gradually progressed up to thighs which worsened during last 15 days. Decreased urine output since 15 days, not associated with frequency, urgency burning
Read more

159 Ravali Irugurala

Image
              General medicine                                        11/11/22 This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's  consent. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs in the comment box below. Note : This is an ongoing case and will be updated regularly.  Date of admission: 9/11/22 Case presentation: A 14 yr old boy came to the opd with complaints of  pain abdomen  in the left side of the abdomen since the past 15-20 days Chief  complaints:   He was having pain abdomen and noticed a swelling in the left side of the abdomen since the past 15-20 days. HOPI: Patient was asymptomatic till 9 years of age. At 9 years of age August, 2016 - parents noticed neck swelling and he had difficulty in swallowing they took him to ENT doctor ,later referred to endocrinologist ,where he was diagnosed with hyperthyroidism. USG showed diffuse enlargement of
Read more