Case study general medicine

C/O DIFFICULTY IN SWALLOWING SINCE 1 WEEK, LOSS OF APETITE SINCE 1 WEEK  DARK TARY STOOLS SINCE 1 WEEK HOPI-PT WAS APPARENTLY ASYMPTOMATIC 12 YEARS BACK THEN HE HAD FEVER,LOOSE STOOLS WENT TO HOSPITAL AND DIAGNOSED WITH ?ACUTE GE  WITH DENOVO HTN. 3YEARS BACK PATIENT HAD FEVER AND GIDDINESS WENT TO LOCAL HOSPITAL AND DIAGNOSED WITH VIRAL PYREXIA WITH DENOVO DM.SINCE THEN PATIENT WAS ON IRREGULAR MEDICATION. HE USED TO TAKE OHA'S AND ANTIHYPERTENSIVES,ON 7/2/22 PATIENT CAME TO GM OPD WITH HEADACHE AND LOSS OF APETITE WAS TREATED ON OP BASIS,AS PATIENT FEELS HIS ATTENDERS ARE NOT WILLING TO SPEND MONEY ON HIS HEALTH ,HE FOUGHT WITH THEM,THEY TOOK HIM TO PRIVATE HOSPITAL ,WHERE CT AND MRI BRAIN WAS DONE AND DIAGNOSED WITH ?NCC/TUBERCULOMA,OPTHAMOLOGY OPINION WAS TAKEN IN V/O RETRORBITAL PAIN AND DIAGNOSED WITH ?OCULAR TB AND PRESCRIBED WITH STEROIDS  E/D PREDNISOLONE 6DROPS/DAY, CYCLOPENTOLATE 3 DROPS/DAY, TIMOLOL 2DROPS/DAY WITH TAB.OMNICORTIL 20 BD AND ALBENDAZOLE 400 BD

CBBLE  UDHC SIMILAR CASE STUDY C/O YELLOWISH DISCOLORATION  of eyes and urine since7-8 days c/o abdominal distension since 7days Hopi-pt was apparently asymptomatic 7 months back,then the first time he had yellowish discoloration of eyes he was admitted to a local hospital and was diagnosed with alcoholic liver disease and was advised to stop alcohol. 2 months back his brother expired,out of agony he again started drinking excess alcohol 180-360 ml since 40 days. patient developed progressive distension of abdomen associated with yellowish discoloration of eyes and urine. h/o fever on and off since 1 week h/o constipation since 2 days no h/o melena,hematemesis,no sleep disturbances Past h/o-not a k/c/o DM,HTN,BA,CVD Treatment h/o-no known drug allergies Family h/o-no significant family history Personal history-pt moderatly built and moderately nourished bowel -constipation since 2 days addictions-alcohol-whisky 180-360 ml daily General examination-pt c/c/c ictreus-present,pedal edema-p

CBBLE  UDHC SIMILAR CASE STUDY C/O GIDDINES SINCE  MORNING HOPI-PT WAS APPARENTLY ASSYMPTOMATIC  TILL MORNING THEN SHE HAD GIDDINESS WHILE GETTING UP FROM THE BED. GIDDINESS WAS SELF RELIEVING SHE WAS  FEELING LIKE FALLING TO LEFT SIDE WHILE WALKING.   PT HAS COMPLAINTS OF HEADACHE(UNILATERAL-LEFT SIDE) AND PHOTOPHOBIO PRESENT.  GIDDINESS CONTINOUS,RELIEVING WITH SUPINE POSITION AGGREVATED WITH CHANGE IN POSTURE PT HAD NO AURAL FULLNESS NO H/O DIZZINESS ON EXPOSURE TO  SOUND. NO H/O DECREASED HEARING,RINGING SENSATION NO WEAKNESS, NO NYSTAGMUS NOT ASSOCIATED WITH VOMITINGS NO H/O ANY TRAUMA /FALL. PAST H/O-NO H/O SIMILAR COMPLAINTS IN THE PAST NO H/O DM,HTN,EPILEPSY, CVD FAMILY H/O-NO SIGNIFICANT FAMILY H/O PERSONAL H/O-PT IS MODERATELY BUILT AND MODERATELY NOURISHED BOWEL AND BLADDER MOVEMENTS-REGULAR NO ADDICTIONS GENERAL EXAMINATION-PT CONSCIOUS,COHERENT AND COOPERATIVE VITALS- BP-110/70 mm HG PR-78 TEMP-AFEBRILE RR-16 SYSTEMIC EXAMINATION- CVS-S1,S2 HEARD,NO MURMURS RS-

CBBLE  UDHC SIMILAR CASE STUDY C/O PAIN ABDOMEN SINCE 1 DAY HOPI-PATIENT  WAS APPARENTLY ASYMPTOMATIC 1  DAY BACK,THEN HE DEVELOPED PAIN IN ABDOMEN WHICH IS SUDDEN IN ONSET,NON PROGRESSIVE,NON COLIKY TYPE,AGGREVATED WITH WALKING,RELIEVED PARTIALLY ON BENDING FORAERD POSITIONPOSITION,ASSOCIATED WITH VOMITINGS-10 to 12 EPISODES,BILIOUS,APPROX-10 ML PER EPISODE,NO AGGREVATING,RELIEVING FACTORS NO H/O FEVER,TRAUMA H/O ALCOHOL INTAKE 2 DAYS BACK. PAST H/O-NOT A K/C/O DM,HTN,BA,EPILEPSY NO H/O SIMILAR COMPLAINTS IN THE PAST  FAMILY H/O-NO SIGNIFICANT FAMILY H/O  PERSONAL H/O-PT IS MODERATELY BUILT AND MODERATELY NOURISHED APETITE-NORMAL BOWEL AND BLADDER MOVEMENTS REGULAR ADDICTIONS-ALCOHOLIC SINCE 10 YEARS QUANTITY-180 ML PER DAY SMOKING CIGARETTES-SINCE 2 YEARS ,DAILY -3-4 CIGARETTES GENERAL EXAMINATION-PATIENT IS CONSCIOUS ,COHERENT,COOPERATIVE VITALS- TEMP-AFEBRILE BP-140/70 mmHg PR-78 RR-17 SPO2-98 @Ra S/E- CVS-S1,S2 PRESENT RS-BAE PRESENT P/A-FLAT,NO DISTENSION,TENDERNESS PRESENT IN EP

C/O  fever since 3 days Dark coloured stools since 2 days HOPI: Patient was apparently normal 3 days back then she developed high grade fever a/w chills Dark coloured stools present No Burning micturition No pain abdomen No neck stiffness Past History -  Not a k/c/o HTN , DM,TB, Asthma , CAD, CVD  Personal history - Diet - mixed Appetite - Normal  Bowel & bladder movements - regular  No addictions Family history - not significant On Examination  patient is c/c/c No pallor , icterus , cyanosis , clubbing lymphadenopathy , edema Vitals - Temp - Afebrile PR - 80bpm BP - 110/80 mmHg RR -16 cpm SpO2- 98%@RA Systemic examination - CVS - S1 S2 +VE  RS -BAE +VE , NVBS +VE  P/A - soft , non tender , BS +ve  CNS - NAD  Provisional diagnosis -  Viral pyrexia  with Thrombocytopenia TREATMENT: 1.IVF 2 UNITS NS @100ml/hr 2.Tab pan 40mg OD 3.Tab PCM 650Mg TID 4.INJ Optineuron 1amp on 100ml NS OD 4.Monitor vitals and inform sos

C/O-PAIN ABDOMEN SINCE 45 days, EPIGASTRIC,DRAGGING TYPE OF PAIN HOPI-PT WAS APPARENTLY ASYMPTOMATIC 45 DAYS AGO THEN HE DEVELOPED PAIN ABDOMEN(EPIGASTRIC REGION) ASSOCIATED WITH NAUSEA AND LOSS OF APETITE NO VOMITINGS NO COMPLAINTS OF CONSTIPATION/OBSTIPATION NO JAUNDICE PAST HISTORY-N/K/C/O DM,HTN,BA,EPILEPSY NO H/O SIMILAR COMPLAINTS IN THE PAST FAMILY H/O -NO SIGNIFICANT FAMILY HISTORY   PERSONAL H/O- PT IS MODERATELY BUILT AND MODERATELY NOURISHED BOWEL AND BLADDER MOVEMENTS REGULAR H/O ALCOHOL INTAKE-REGULAR,TODDY SINCE 15  YEARS,WHISKY 250 ML ONCE IN 2 DAYS  FOR 1 YEAR. No OTHER ADDICTIONS GENERAL EXAMINATION- PT C/C/C NO PALLOR/ICTREUS CYANOSIS/EDEMA/LYMPHADENOPATHY VITALS- TEMP-AFEBRILE BP-110/80 PR-90 RR-20 SPO2-98% AT RA SYSTEMIC EXAMINATION- CVS-S1,S2  HEARD,NO MURMURS RS-BAE PRESENT,NVBS HEARD P/A-SOFT,NONTENDER,BS+ CNS-NAD DIAGNOSIS- ACUTE PANCREATITIS? TREATMENT- 1.IVF NS/RL/DNS -100 ML/HR 2.INJ PAN 40 MG IV/OD 3.INJ ZOFER 4MG/IV/SOS 4.INJ TRAMADOL 1 AMP/IV/SOS IN 10