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?







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