A 68 YEAR OLD FEMALE PRESENTED WITH VOMITINGS AND DIARRHEA

Name: DR.Y.NAVYA SAHITHI REDDY(INTERN)
Roll no: 167
Date: 19/6/23

This is an online E logbook to discuss our patients' 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 the available global online community of experts intending to solve those patients clinical problems with the collective current best evidence-based inputs. This e-log book also reflects my patient-centred online learning portfolio and your valuable inputs on the comment box are welcome. 

A 68year old female presented to the casualty with cheif complaints of
Vomitings since yesterday evening
Loose stools since yesterday evening

HOPI:

Pateint was apparently asymptomatic till yesterday evening then she developed vomiting which are non projectile , non billiary without food particles of 6-9 episodes since yesterday evening and she had loose watery stools of 5-6 episodes along with vomitings .patient had history of eating fish yesterday morning.
Not associated with fever, chills and rigor, dizziness, shortness of breath, chest pain, palpitations , b/L pedal edema and no burning micturition
PAST HISTORY:
Patient was a not a k/c/o DM -2, Hypertension, asthma, thyroid disorders  epilepsy, CAD ,TB
Patient had h/o cholelithiasis diagnosed by USG abdomen ans pelvis 8 uears back for which she did not take any medications or surgery.
H/o surgery for intestinal perforation 10 years back.

TREATMENT HISTORY:
Patient had h/o surgery for intestinal perforation 10years back.

PERSONAL HISTORY:
DIET: Mixed
Appetite: reduced since yesterday evening
Sleep: reduced since yestetday evening
Bowel and bladder movements: Regular
Mictiurition: Normal

GENERAL EXAMINATION: 

Patient was concious, coherent,cooperative,well nourished and heavily built
There is no pallor, cyanosis, lympadenopathy, clubbing, icterus, edema.
Vitals:
Temp: 98.4F
Pulse rate-99/min
Redpiratory rate- 18/min
BP: 110/60mm of hg
Spo2:93%
GRBS:121 mg %


Systemic examination:

CVS: S1 and S2 are heard.
No murmurs and thrills.

Respiratory examination:
There is no dysnoea,wheeze.
Breath sounds are vesicular.

Abdominal examination:

Inspection:
Shape of the abdomen:scaphoid
scar is presnt on the midline of abdomen of 10cm 
No sinuses.
No engorged veins.

Palpation:
No Tenderness is present in epigastric region.
Liver and spleen are not palpable.
Bowel sounds are heard 


CNS:
NAD
Provisional diagnosis  
ACUTE GASTRO ENTERITIS


Questions:.
1) WHAT ARE THE CAUSES FOR ACUTE GASTROENTERITIS.?
2) WHAT ARE THE PATHOGENIC ORGANISIM SEEN IN THIS CASE?
3) WHAT IS INFECTIOUS GASTROENTERITIS?
4) HOW DOES INFECTIOUS GASTROENTEISTIS SPREAD?
5) WHAT ARE THE MAJOR COMPLICATIONS SEEN IN THE CASE OF GASTROENTERITIS?







Comments

Post a Comment

Popular posts from this blog

INTERNAL ASSESMENT

Image
⁰ 10 Marks questions: 1 )Define bone density, how is it measured? What are the causes, clinical features,diagnosis and management of osteoporosis? (1+2+2+2+3) Bone density, or bone mineral density, is the amount of bone mineral in bone tissue.  Bone density measurements are used to diagnose osteoporosis . A bone density test is used to measure bone mineral content and density. It may be done using X-rays, dual-energy X-ray absorptiometry (DEXA or DXA), or a special CT scan  It is painless and tests the risk of fracture due to osteoporosis.  Osteoporosis is characterized by decrease in the amount of bone. Causes: primary- postmenopausal women and older men                      Secondary- cancer,COPD,CKD,certain drugs,                                                    Endocrine diseases.  Clinical features: usually asymptomatic                                Back ache or spontaneous fractures may be seen. Investigations: x rays showing osteopenia                
Read more

General medicine online assignment(covid case 23)

  Y.Navya sahithi reddy rollno 146 8th semster COVID-19 CASE -23 Covid 19 with multiple comorbidities: 1 )What do you think are the factors in this patient that are contributing to his increased severity of symptoms and infection?  Ans: As the patient has previous past history of : Type 2 Diabetes Mellitus since 7 years  Chronic Kidney Disease since 2 years Pulmonary Kochs: 7 years back for which he took 6 months of ATT. Bronchial Asthma since 7 years  Chronic NSAID use: since 1991 for knee pain  Getting admitted to a Hospital in 2019 for B/L Pneumonia. These above factors are contributing to his severity of symptoms and infection. 2.Can you explain why the D dimer levels are increasing in this patient?  Ans:The liver produces several important proteins involved in the coagulation process, one of which includes fibrinogen. A single fibrinogen molecule is a symmetrical dimer that is made up of three pairs of three different polypeptide chains, which include a, b and g. Each of the inter
Read more

39 YEAR OLD WITH SHORTNESS OF BREATH

Image
Y.Navya sahithi reddy Roll no.1701006200 2017 batch I have 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 diagnosis and treatment plan A 37 year old male came to opd with c/o shortness of breath grade 4 since 3 months . HISTORY OF PRESENTING ILLNESS:-  Patient was apparently asymptomatic 2 years back ,  then the patient had an episode of giddiness ?due to shock (from the death of his brother in law) ,for which he went to a local hospital and got diagnosed with hypertension. Since then the patient was started on increasing doses of Telma and later Telma -H, but the patient was not compliant to the medication. He used to take the medication only when there's occasional neck stiffness and pain. History of mild shortness of breath and chest pain 3 months back, not associated with cough, fatigue
Read more