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A18 year y female, fever with thrombocytopenia

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Unit 1 admission  Ward case  Dr K VAISHNAVI PGY3  DR NIKITHA PGY3  DR RAVEEN PGY2 A 18  year old female , student  presented to the casuality with  C/O fever with chills since 10  days  H/o nausea present  No H/O bleeding manifestions  Pt was apparently asymptomatic 10 days back ,later she developed high grade continuous type of fever subsided on medication associated with chills and  aggravated since 4 days   History of cold present 10 days back  subsided on taking medication,diurnal variation absent  History of cough with mild scanty sputum ,mucoid in constistency Not associated with giddiness  Head ache +,myalgia +  Past history :  Not a K/C/O DM,HTN,Asthma ,TB,epilepsy  No similar complaints in the past  Personal history :  Diet - mixed  Appetite - decreased  Sleep - adequate  Bowel movements : regular  Bladder movements : regular  No history of smoking or alcohol consumption  O/E: Pt is conscious,coherent and cooperative  Vitals:  Afebrile to touch BP: 110/70 PR: 82  bpm RR: 16 Sp
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20 year female with fever with thrombocytopenia.

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Patient came to the casualty with the complaints of fever since 5 days. Patient was apparently asymptomatic 5 days back then she developed fever which is on and off,not associated with chills and rigors and which was subsided on taking medication. And there is h/o vomiting (1episode),which is non bilious,non projectile,food as a content. And  there is h/o melena, and black coloured stools since 2days. O/E:  USG REPORT: Gall bladder wall edema. Chest X-ray Patient c/c/c Bp:120/80 Pr:70bpm Grbs:102 Cvs:s1s2+ CNS:NAD+ Rs:BAE+ P/A: soft and non tender Bowel sounds are heard. Investigation: Hemogram: Hb:12.6 TLC:4000 Platelets:1lakh Pcv:41.6 Rft:  Sodium:140 Potassium:5.4 Chloride:99 Lft: Tb:0.68 Db:0.18 Sgot:39 Sgpt:11 Provisional diagnosis: Fever with  thrombocytopenia.(ns1 positive) Treatment:  Inj.pantop 40 mg/iv/od Inj.zofer 4 mg /iv/sos T.pcm 500mg/po/sos
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50 year old male with chronic pancreatitis with mild ascites.

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Chief complaints:- A 50 year old male came, working as a daily wage labourer from Nagonda presented  to the casualty yesterday with the complaints of  Pain abdomen since 1 week. Hopi:-  Patient consumes around 90ml of whiskey everyday since the past 10 years and he also smokes 1 pack of cigarettes per day.  He was apparently alright 7 years back then he developed pain abdomen around umbilical region which was non radiating and dull aching in nature, present throughout the day and wasn't relieved on sitting or bending forward. He went to a local hospital when in he was admitted for 4 days and continued to consume the prescribed medications for 1 week post admission. He thereafter stopped consuming alcohol for 7 months post admission. He later continued consuming alcohol. 1 month later he developed a similar episode of pain abdomen for which he used the medications prescribed as per his previous hospital admission. 4 years back - He experienced pain abdomen for which he consulted a d
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25 year old male with fever with thrombocytopenia

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Patient came to the OPD with complaints of fever since 10 days. Patient was apparently asymptomatic 10 days back then he developed fever,which is on and off,high grade fever, associated with chills and rigors.which was subsided on taking medication.After 2 days again he developed fever,for that he went to local hospital there he diagnosed with typhoid for that he used medication. After 3 days ,he had fever,which is low grade fever not associated with chills and rigors.for the he went to local hospital there he had a dengue positive. O/E Patient c/c/c Afebrile Bp:100/60 PR:75 bpm Cvs:s1s2+ CNS:NAD+ Rs: BAE+ P/A:soft and non tender Investigation: ECG: Hemogram: Hb:15.6 TLC:7,500 Pcv:44.5 Platelets:1.17lakhs Lft: Tb:1.25 Db:0.48 Sgot:123 Sgpt:86 Rft: Sodium:138 Potassium:4.5 Chloride:99 Blood urea:18 Sr.creatinine:0.7 Provisional diagnosis: Fever with thrombocytopenia.(ns1 positive) Treatment: inj.pan 40 mg/iv/od Inj.zofer 4mg/iv/sos T.pcm 5
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A long distance patient with left frozen shoulder

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A long distance patient came to the OPD with regulur check up. C/o left frozen shoulder since 10months back. Patient was apparently asymptomatic 10 months back.then he had left shoulder pain which is radiating and not associated with trauma. H/o frozen shoulder 10month back.e had on medication 15 years back, relieved on medication. He is k/c/o  HYPERTENSION, DIABETESsince 6 years. Thyroid since 2 years. O/E: Patient c/c/c Afebrile Bp:130/80mmhg PR:98bpm Cvs:s1s2+ CNS: NAD+ Rs:BAE+ P/A:soft non tender Bowel sounds are heard. Investigation: ECG: Chest X-ray: 2d echo: Provisional diagnosis: Left frozen shoulder with hypertension, diabetes, thyroid. Treatment: Azulix 2 MF (glimiperide 2mg+metformin 500mg)/po/od. Telma 40mg po/Od Clinidipine 10mg/po/od T.ultracet po/qid Thyronorm  75 mg/po/od
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A long distance patient with chronic kidney disease with diabetes

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 patient came to OPD for regular check up Patient has history of constipation since 10 years for that she was took medication intermittently.And in the year of 2014 she was diagnosed with diabetes for that she is using T.Linagliptan-5 mg od. After that in the year of 2016 she had complaints of vomiting (7episodes)for which she went to hospital the she diagnosed with UTI and AKI on CKD.Again in the year of 2018, she had complaints of vomiting (10 episodes), consisting of food particles,non bilious, non blood tinged. For that she went to near by hospital and she had UTI ang High blood sugar(500mg/dl).And they given treatment for 15 days. Complaints didn't subsided.Then, they referred to higher centres(kolkata).Then, they confirmed that she had hyperkalemia and they indicated dialysis.There she undergone 1session of dialysis.And symptoms were subsided . After 6 months of recovery she had complaints of vomiting,and treated conservatively.again in the year of 2019 she complaints of
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A 50 year old male with acute Gastroenteritis

UNIT 4 ADMISSION:- A 50 year old male came to casuality with complaints of Vomiting since 2 hours Loose stools since 2 hours HOPI: Pt was apparently asymptomatic 2 hours back then he had vomitings 4-5 episodes, nonbilious in nature,non projectile, food particles as content and h/o loose stools since 2 hours,watery in consistency,  No h/o fever,cold,cough, burning micturition  No h/o pain abdomen Past history: No similar complaints in the past He is a a k/c/o HTN since 3 years and on Tab.telma 20 mg Po/od and  Depression and on tab.sizdon 25mg Po/od Not a k/c/o DM type 2/ASTHMA/EPILEPSY/TB He is a non alcoholic and non smoker O/E:  Pt is conscious , oriented to time , place , person   No pallor , Icterus, cyanosis , clubbing, lymphadenopathy , edema.  Vitals:  Temp - 98.7 BP - 90/60mm of hg PR - 112 bpm  Spo2 - 96%at RA  RR- 18cpm GRBS - 149 mg/dl  Systemic examination:  Cvs: s1 s2 present , no murmurs Rs: BAE present, normal vesicular breath sounds present.  P/A: soft, non tender 
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