General medicine case presentation

 This is an 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 34 year old male patient who is working at store to print wedding cards  from Suryapet came to casuality with cheif complaint of abdominal pain since 20 days.vomitings since 20 days .

History of present illness:

Patinet was asymptomatic 2 years back . Patient has habit of drinking alcohol from 15 years . He drinks 360 ml/day . Since last 2 years patient is suffering with recurrent episodes of abdominal pain and recurrent episodes of vomitings.Abdominalpain gets relieved on sitting.patient is lossnot consuming sufficient amount of food due to loss of appetite . 

Since last 20 days patient experiencing generalized weakness so that he stop going to work.he also experiencing dysopnea and 1 episode of  vomiting blood tinged .and dark coloured stools . He also experiencing low grade fever intermittent no diurinal variation. He also lost s weight.around 12 kgs . He also  have increased  abdominal pain  in epigastric region.patient became anemic . 

History of past illness:

Patinet is not a known case of Diabetesmellitus, hypertension,asthma , tuberculosis,jaundice , epilepsy.

Family history: 

No similar complications seen in family members.

Drug history : 

patinet is not allergic to known drugs

Personal history: 

Diet : mixed

Appetite: lost

Sleep: adequate

Bowel and bladder movements ; constipation

Micturation: normal

Habits: alcoholic , occasionally smoking.

Allergies : no known allergies


General physical examination:

Patinet is pallor 




No cyanosis

No icterus 

Malnourished

No clubbing of fingers

No lymphadenopathy

No edema of feet 

Vitals : 

Temperature: 98°F

Pulse rate : 84 bpm

Respiration rate : 18 cycle per min

Bllod pressure :120/89 mm hg

GRBS 102 mg 

Spo2 99%

Systemic examination:

Cardiovascular system:

S1 and  S2 heard 

No murmurs heard


Respiratory system:

Location of trachea central

No wheezing sounds

Breathing sounds vesicular.

Abdomen:

Shape of abdomen : scaphoid 

Abdominal tenderness grade 1 pain

No palpable masses

Hernial orifice is normal

Bowel sounds yes.


Level of consciousness:

Patient is conscious, coherent,and cooperative to time and place.

Speech is normal

Motor , sensory system noramal

All reflexes are normal.

Provisional Diagnosis: chronic pancreatitis.

Investigations:



















Treatment:
1.injection pan 40 mg IV od
2.injection zofer 4 mg IV tid
3.inj.Tramadol 1 ampl in 100 ml NS IV BD
4. Plan for 1 pRBS transfusion.
5.injection Thiamine 1 ampul 100 ml tid IV
6. Tab dolo650  mg DO sos
7. Moniter vitals
8. Inform sos
9. Injection iron sucrose 1ampoul in 100 m
L NS Iv od .




Comments

Popular posts from this blog

Thakurshalini general Medicine case presentation 1

Prefianl examination answers