36 YEAR OLD FARMER BY OCCUPATION CAME WITH COMPLAINTS OF VOMITINGS SINCE MORNING AND GENERALISED WEAKNESS 

PATIENT WAS APPARENTLY ASYMPTOMATIC TILL YESTERDAY THEN HE HAD 

VOMITINGS (10-20 EPISODES SINCE MORNING) CONTAINS FOOD PARTICLES , NON

BILIOUS, NON PROJECTILE , ASSOCIATED WITH STOMACH PAIN DIFFUSE TYPE.

NO COMPLAINTS OF FEVER, CHEST PAIN, COLD, COUGH, SOB ,BURNING MICTURITION ,

CONSTIPATION, WEIGHT LOSS, HEAD ACHE, EGIGASTRIC PAIN, BLURRING OF VISION, 

PALPITATIONS, LOOSE STOOLS

NOT A K/C/O HYPERTENSIVE AND DIABETES 

K/C/O ALCOHOLIC SINCE 10 YEARS ( WHISKEY 90ML)

CHEWS TOBACCO SINCE 10 YEARS 

NO SIMILAR COMPLAINTS IN THE PAST.


ON EXAMINATION :

PATIENT IS C/C/C ,  MODERATELY DEHYDRATED.

AFEBRILE , NO PALLOR , CYANOSIS , CLUBBING, LYMPHADENOPATHY, EDEMA

ICTERUS +

BP:110/80 mmhg 

PR: 80bpm /regular 

P/A : SOFT, NO TENDERNESS PRESNT 


INVESTIGATIONS:

RFT:

UREA: 29

CREATININE: 1.2

CALCIUM: 10.2

PHOSPHORUS: 3.9

SODIUM: 141

POTASSIUM: 3.0

CHLORIDE: 94

SERUM LIPASE: 26IU/L

SERUM AMYLASE: 64IU/L

LFT:

TOTAL BILIRUBIN: 3.97

DIRECT BILIRUBIN: 1.18

SGOT: 43

SGPT: 29

ALKALINE PHOSPHATE :196

TOTAL PROTEINS:8.3

ALBUMIN: 4.8

A/G RATIO: 1.38

USG SUGGESTIVE OF GRADE 2 FATTY LIVER 

HB - 15.5 

TLC : 14,200

NEUTROPHILS : 88

LYMPHOCYTES : 05

EOSINOPHILS : 03 

MONOCYTES : 04

PLATELETS : 1.95


PROVISIONAL DIAGNOSIS: ALCOHOLIC LIVER DISEASE WITH ACUTE GASTRITIS WITH  HYPOKALEMIA AND ALCOHOL DEPENDENCE.

Comments

Post a Comment

Popular posts from this blog

PRE FINAL PRACTICAL (45 year old male with giddiness) LONG CASE

Image
Presenting complaints :  45 year old male who is a resident of Narketpalli driver by occupation , came to the casuality who studied till degree came with complaints  of : Giddiness since yesterday afternoon    vomiting’s 4 episodes  since afternoon  shivering since afternoon which lasted till he was brought to the hospital subsided on medication .  HOPI & PAST HISTORY :  He’s the last child in his family . Mother and father expired at 20 years    , mother expired because of paralysis . Father expired because of ? Renal issues .  Marriage : consanguinity ( first degree ) at 20 years survived with 2 kids (2sons ) one son is intern completed and other is working in hyd in a laboratory.  20 years back he worked in an pharmacy for 3-4 years , then he owned his own auto and drove for 3-4 years , later he brought his car gave it for trips ,and he worked    a private driver , and also used to drive hens to chicken shop , He’s an night driver , he used to leave home at 7:30 pm and come bac
Read more

MARCH EXAM

  Internal assesment to the questions asked in the above blog spot. 1) Please go through the patient data in the links below and answer the following questions: https://ashakiran923.blogspot.com/2021/03/60-years-old-male-fever-under-evaluation.html?m=1 a). What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings?How specific is his dilated superficial Abdominal vein in making diagnosis? Abdominal distension with clinical Image of umbilicus everted : Ascitis  Decreased urine output with burning micturition : renal pathology But is GI pathology causing renal or renal causing git or is that both are independent entities is we are not sure off. b) What is the etiology of the current problem and how would you as a member of the treating team arrive at a diagnosis? What is the cause of his hypoalbuminemia?Why is the SAAG low? Etiology : GIT ascitis pathology would be known by doing SAAG and his pain abdo
Read more

KHL Diaries

Image
  This is a case of atrial myxoma ,which I accompanied the surgeon during my posting in KHL cardiology 🫀 It was very kind of the DR. VISHAL sir (Departemnt of CTVS )  to allow me to watch    During the surgery , the surgeon , made me feel the Heart, I couldn’t thank him enough for making it so special .  Even though it has been the most painful, awful experience in some ways, it’s absolutely amazing in others. It’s changed my life and put everything into perspective.   This is a picture where sir , is explaining  me the chambers of the heart and his approach of going to perform the surgery , what are the risks associated during the surgery , It was indeed a treat to eyes.  I’m thankful to the department of cardiology (KHL) for teaching how to handle cases , how to perform echo, how to be a good physician and listen to the patient’s complaints because they teach us medicine.  Ending with a quote -NO BEAUTY SHINES BRIGHTER THAN A HEALTHY HEART .
Read more