Posts

Provisional diagnosis: ALCOHOLIC GASTRITIS ACUTE PHARYNGITIS (? REACTIVE ? INFECTIVE ) WITH AKI RESOLVED DENOVO DM ( HBA1C 6.9)

Image
Patient came to casuality wih c/o epigastric pain since 2pm of 27/2/22. Nausea and vomitings are present since 4pm yesterday.  HOPI:  Patient is a chronic alcoholic since 20yrs. Due to issues with his wife, he is consuming alcohol since 1yr. For the last 7days he is drinking wihout having food. C/o epigastric pain since yesterday  Burning type, radiating to back gradually progressive.  Nausea present, vomitings present of dark black colored. Non bilious, non projectile. C/o Burning sensation in throat Similar episode of binge drinking 2 eisodes in last 1yr. K/C/O HTN since 5yrs , on medication - irregular.  N/K/C/O: DM, TB, asthma. O/E: Pt is C/C/C. Afebrile. Bp: 120/80 Pr: 84 bpm Rs: BAE+ CVS: S1S2 + CNS: NAD. Abdomen : soft and tender at left hypochondrium  After  TREATMENT :-  1) INJ PANTOP 40 MG OD  2) INJ THIAMINE 100 MG IV BF  3) IVF  NS AND RL  4) INJ ZOFER 4 MG IV SOS  5 ) INJ PIPTAZ 2.25 MG IV TID DAY 3  6)BETADINE GA
Read more

IRON DEFICIENCY ANEMIA HEPATOSPLEENOMEGAlY+DELAYED PUBERTY (absence of thelarche by 13 y) Growth retardation ? SECONDARY TO NUTRITIONAL CAUSE

Image
AMC case  17/F  patient came with chief complaints of sob  on exertion since 2 months  HISTORY OF PRESENT ILLNESS :-  patient was apparently asymptomatic  2 months ago then she developed  sob on exertion  grade 2. she went to get covid vaccine  2 days back  and when she got blood investigations she got hemoglobin 2.3  she complaints of chest pain  on and off  since 2 months  she complains of generalized weakness  c/o palpitations since 2 months  no meleana / hemorroidhs  no past h/0 surgeries  she attained menarche  6 months ago  3-5 /30 , 2-3 pads/day fully soaked  one unit of prbs was done on the day of admission  One unit of prbs was given on 2/3/22 no pain , no clots  PAST HISTORY :-  no  past h/0 of blood transfusion  N/k/c/o asthma , htn, dm , epilepsy  on examination :-  patient was conscious , coherent , co operative  pallor   present cyanosis, icterus , lymphadenopathy, edema , are absent  vitals :-  temp 97.3F PR. 98 bpm bp 110/50 mm hg RR.  16cpm spo2   99% systemic examinat
Read more

ALTERED SENSORIUM UNDER EVALUATION WITH BED SORE GRADE 2 AND RIGHT UPPER LOBE CONSOLIDATION

Image
A 90 years old female  came with chief  complaints of decreased response  since morning HISTORY OF PRESENT ILLNESS :-  patient was apparently asymptomatic    20 days before.then she gradually reduced doing her regular works, and  few days  later  she bed ridden and used to eat food when attenders feed her.once suddenly when the patient attenders giving bath to  her  noticed a ulcer on the right hip region  which is circular in shape , margins are irregular. when they noticed the ulcer called a rmp doctor he  advised a  local application which is a powder, and daily they are applying that powder and staying at home. on the day 13/2/22   she ate 2 spoons of feeding  at night, and she spoken to the attenders as usual on the day 14 /2/22 when they are supposed to    feed  her with bread slices with milk  she refused to eat  as she is having bitter taste..and then after she  became semi consciousness and  rolled her eyes upwards, then the attenders brought her to the hospital . HISTORY OF P
Read more

VIRAL PYREXIA WITH THROMBOCYTOPENIA

Image
45 year female came with chief complaints of fever since 3 days  HISTORY OF PRRSENT ILLNESS :-  patient was apparently asymptomatic 10 days before  she had fever which is mild degree of fever subsided with medication by a local rmp. after one week she developed fever again where the attenders brought here to the hospital  with chief complaints of. fever  which is high grade fever , intermittent , aggrevating at night time , associated with  chills  and sweating at the duration of fever . and pain at the both  eye brow region. and pain of lower limbs which is dragging tyoe of pain and relieved when the fever subsided . the patient also complains of  discomfort in the abdomen since 1 days . PAST HISTORY  K/C/O  htn since 6 months and she is on medication  Not a k/c/0 dm, asthma , epilepsy  PERSONAL HISTORY :-  appetite : decreased  Diet : vegeterian  Sleep : adequate  Bowel and bladder:  regular  No addictions  FAMILY HISTORY :-  not significant  ON EXAMINATION :-  Patient is conscious ,
Read more

CHRONIC PANCREATITIS WITH PSEUDOCYST

Image
A 27 years male patient occupation by electrician came with chief complaints of pain abdomen since 3 months  HISTORY OF PRESENT ILLNESS :-  patient was apparently a symptomatic 3 months back, then he had a trauma where his relatives beaten him with stick at the left hypochondrium region and  then he developed mild diffuse abdominal pain associated with bilious vomiting .projectile .contains food particles , then the pain subsided on taking medications  After a few days he again developed pain abdomen at the left hypochondrium region and the pain radiating to back , then he went to government hospital where he under went treatment but the symptoms didn't subsided  So he went to a private hospital we he took treatment but in the middle of treatment , he tested postive in the hospital , so he went to home isolation , were he approached a local  rmp for the pain abdomen and covid . After  5 days he tested negative in mid of January  so he went back to the same private  hospitaland unde
Read more

1601006197 LONG CASE

Image
1601006197 LONG CASE  This  is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.  Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome I've been given this case to solve in an attempt to understand the topic of "patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan.  A 65 yr old woman, from narketpally who is house wife ,came to hospital with chief complaints of  fever with chills since 8 days and pain abdomen since 6 days
Read more

1601006197 short case

Image
1601006197 SHORT CASE                  Hall ticket number 1601006197 Case: A 55year old male toddy climber by occupation came with complaints of pain abdomen and fever. Following is my analysis of this patient's problem: The problems in order of priority I found are  1) Severe pain abdomen since 14 days 2) Fever since 7days Chief complaints:                               A 55 year old male patient,toddy climber by occupation, resident of miryalguda,came with complaints of  1)pain abdomen since 14days 2) Fever since 7 days  HISTORY OF PRESENTING ILLNESS:           Patient was apparently asymptomatic 14 days back and later developed -        -severe pain abdomen in the right upper      ~   Region- -right upper quadrantof abdomen ,.         ~ Onset.  - sudden        ~ Gradually progressive       ~ Type - dragging type        ~non radiating pain.       ~ Aggravating  on standing position        ~ Relieved for   sometime upon taking medication.  And pain abdomen not associated with naus
Read more