1st internal examination

Comments

Post a Comment

Popular posts from this blog

ALTERED SENSORIUM SECONDARY TO HYPONATREMIA EUVOLEMIC ? SIADH ? WITH HYPOKELEMIA WITH SMALL HEMORRHAGIC CONTUSION FRONTAL LOBE WITH AKI ( RESLOVING ) WITH HYPERTENSION SINCE 4 YEARS,WITH TYPE 2 DIABETES SINCE 18 YEARS

Case History and Clinical Findings  A 60 YEAR OLD MALE WAS BROUGHT TO CASUALITY IN ALTERED SENSORIUM SINCE YESTERDAY NIGHT PATIENT WAS APPARENTLY ASYMPTOMATIC 10YEARS BACK THEN HE DEVELOPED DM-2 SIMILAR EPISODE THEN HE DIAGNOSED TO HAVE DM-2 AND STARTED ON OHA LATER AFTER FEW YEARS PATIENT WAS SHIFTED TO INSULIN 4YEARS BACK PATIENT DEVELOPED GIDDINESS AND WHILE WORKING PT HAF FALL, FRACTURE RT UL &RT LL, DIAGNOSED WITH HTN ( ON TAB.METOSARTAN CH50, METOPROLOL 50, TELMA 40 ) 2 YEARS BACK PT DEVELOPED SIMILAR COMPLAINTS OF ALTERED SENSORIUM AND WAS HAVING HYPERGLYCEMIA AT PRIVATE HSPTL THEN WAS DIAGNOSED TO HAVE ? DKA ; -GIVEN INSULIN AND TREATEDAFTER THAT;10 DAYS BACK PATIENT DEVELOPED SWELLING OF LOWER LIMBS AND ULCERATION ON RT TOE AND PLANTAR ASPECT OF FOOT FOR WHICH HE WENT TO PUT PRACTITIONER AND DIAGNOSED TO HAVE DIABETIC FOOT AND WAS TREATED WITH REGULAR DRESSINGS AND ANTIBIOTICS LATER 4 DAYS BACK PATIENT DEVELOPED NAUSEA , VOMITING - 2 EPISODES / DAY ASSOCIATED WITH FOOD...
Read more

ALTERED SENSORIUM SECONDARY TO SEPTIC ENCEPHALOPATHY ?UREMIC ENCEPHALOPATHY(RESOLVING)HYPOGLYCEMIA(RESOLVED) WITH ULCER OVER ANTERIOR ASPECT OF LOWER LIMB SECONDARY TO FILARIASIS WITH AKI(PRE RENAL)WITH K/C/O HTN SINCE 10 YRS,K/C/O CAD SINCE 2 YRS S/P : 5 SESSIONS OF HAEMODIALYSIS DONE

Case History and Clinical Findings  PATIENT WAS BROUGHT TO CASUALTY WITH COMPLAINTS OF PAIN ABDOMEN SINCE 4 DAYS AND SWELLING OF LEFT LOWER LIMB SINCE 4 DAYS  HOPI:  PATIENT WAS APPARENTLY ASYMPTOMATIC 4 DAYS AGO THEN SHE DEVELOPED PAIN ABDOMEN WHICH IS INSIDIOUS IN ONSET GRADUALLY PROGRESSIVE. NO AGGRAVATING AND RELEIVING FACTORS. SQUEEZING TYPE OF PAIN PRESENT. H/O FEVER CONTINUOUS TYPE AND RELEIVED ON MEDICATION H/O ANOREXIA,NAUSEA PRESENT NO H/O VOMITINGS H/O ITCHING PRESENT OVER LEFT LEG 5 DAYS AGO K/C/O HTN AND ON REGULAR MEDICATIONN/K/C/O TB,ASTHMA,DM,CVA,CAD,THYROID DISORDERS,EPILEPSY PERSONAL HISTORY:APPETITE IS NORMALDIET IS MIXEDSLEEP ADEQUATEBOWEL AND BLADDER REGULARADDICTIONS- NO FAMILY HISTORY: NO RELAVANT FAMILY HISTORY GENERAL EXAMINATION: PATIENT IS CONSCIOUS, COHERENT,COOPERATIVE.MODERATELY BUILT AND NOURISHEDNO SIGNS OF PALLOR,ICTERUS,CLUBBING,CYANOSIS,LYMPHEDENOPATHY, VITALS:TEMP: 98.6FPR: 78BPMBP: 130/90MMHGRR: 18CPM CVS: S1S2 HEARDRS: BAE+ P/A: SOFT ...
Read more

ALTERED SENSORIUM SECONDARY TO HYPOGLYMEIA (RECOVERED) HYPONATREMIA

Case History and Clinical Findings Altered behaviour since1 hr Difficulty in swallowing since 4 days 65 year old female patient non diabetic non hypertensive who is a Telugu tutor at home and was able to do all her house hold works on her own till 2006 then from 2006 she was getting water from step well then she got her hipand knee pains from 2008 where they took to hospital they suggested for surgery but Attendors neglected it because of financial issues then from that time patient was slowly walking from 1 year she started walking with the support(wall) and do her own works then from few days she is walking with walker . Patient had odynophagia since 4 days then she did not take food and on the day of admission she got up in the mrng and was oriented to place time and person then after some time she was not oriented to person since afternoon then they brought patient to the hospital with complaints of Altered behaviour since1 hrDifficulty in swallowing since 4 days Past history : N/K...
Read more