case of UTI

Case of UTI..
65 yr old female came with C/o 
---burning micturition since 4-5 days
---Decreased urine output since today morning 
---Pedal edema since 5-6 hrs 

HOPI : 
Patient was apparently asymptomatic 4 to 5 days ago then she developed
BURNING MICTURITION 
No h/o    loin pain , pain abdomen, fever & chills , vomitings, diarrhoea, itching in genital region, white discharge . 

C/o  DECREASED URINE OUTPUT  since one day, only few drops of urine was passed  &  went to the outside Hospital where the treatment of INJ. LASIX 40 mg was given after which she passed the urine 
No h/o fever, vomitings,diarrhoea 
No h/o hematuria , loin pain 

 C/o bilateral PEDAL EDEMA , insidious in onset, gradually progressive, pitting type , grade 2 ( upto knees). 
No h/o of exertional dysnea, orthopnea , PND, 
NO h/o of jaundice , pruritus , facial puffiness 

HISTORY OF PAST ILLNESS: 

k/c/o HTN since 6yrs & using T.TELMA mg OD 
N/k/c/o of Dm, BA, TB, EPILEPSY, CVA , THYROID DISORDERS . 

PAST SURGICAL  HISTORY : Hysterectomy 4yrs ago. 

 PERSONAL HISTORY : 
Diet : mixed
Appetite : normal
Sleep : adequate 
Bowel & bladder habits : regular, Burning micturition + 
No known addictions 

EXAMINATION : Pt is c/c/c
VITALS : 
TEMP : 98.6 f
HR : 75bpm
BP : 140/80 mm hg
RR : 18cpm
SPO2 : 98 % @RA
GRBS: 111mg/dl 

P/A : soft, obese ,suprapubic tenderness+ 
CVS : s1, s2 + . No murmurs 
RS : bae + NVBS + 
CNS  : NAD 

INVESTIGATIONS : 
CBP :
 Hb: 11.5
TLC:10,400
PLT: 5.57
N/L/M/E: 55/37/5/3

LFT : 
TB-0.98
DB-0.18
AST -25
ALT- 20
ALP-175
TP-6.8
A/G - 3.9

RFT :
SR.Cr - 1.1
Na+/k+/cl-  : 131/3.6/98
 
DIAGNOSIS :  ? Cystitis with AKI 
TREATMENT : 

1) IVF NS & RL @urine output + 30ml / hr
2) INJ. PANTOP 40mg i.v BD 
3) Inj. LASIX 20mg i.v BD

Comments

Post a Comment

Popular posts from this blog

case of hyponatremia 18/08/22

Image
A 46 year old male presented with CC of  ✓ Vomitings Since 10 days ✓ Fever since 10 days  ✓ Generalised weakness since 10 days  HOPI- Patient was apparently asymptomatic 1 year back then he had vomitings 1 to 5 episodes/day, non bilious, non projectile, non blood tinged for which he went to a govt hospital & got treated. Prior to vomitings patient had 360 ml of alcohol. Then after 2 days he had involuntary movements of both upper & lower Limbs - 1episode, which is associated with froathing, tongue bite. Patient was unconscious during this episode. He was taken to a private hospital & managed conservatively. 10 days back patient had vomitings 2-3 episodes per day, non projectile, non-bilious,  food particles as contents and not associated with pain in the abdomen. Patient had fever associated with evening rise of temperature, chills, which is intermittent and relieved on medication. Generalized weakness and Drowsiness since 10 days. Past History - Not a known cas
Read more

39 year old with ascites

Image
December 07, 2023 This is a case of a 39 year old bus driver who is a resident of West Bengal. CHIEF COMPLAINT: Abdominal distension since 2 months. Swelling in the leg since 2 months. Decreased appetite since 2 months. Decreased urine output since 1 month.  HISTORY OF PRESENT ILLNESS- Patient was apparently asymptomatic 2 months ago then he developed abdominal distension which was insidious in onset and gradually progressive, associated with decreased appetite. Later he developed bilateral pedal edema extending upto the knees which is of pitting type. After a month his urine output got decreased still he continued his work as a bus driver. His relatives started noticing that his abdomen is getting distended and his appetite is decreased. They suggested him to see a doctor following which he took a homeopathic treatment in West Bengal But there was no improvement. He also took some ayurvedic medication but nothing seemed to work out. Then he came to our hospital with complaints of abdo
Read more

prefinal osce and learning points

Image
OSCE AND LEARNING POINTS PREFINAL PRACTICAL EXAMS NAME : LEKHANA ROLL NO: 64 DATE: 8 DECEMBER,2023 Blog link: 1) AUTOIMMUNE HEPATITIS: -Autoimmune hepatitis is when the body’s infection-fighting system (immune system) attacks your liver cells. -It is a long-term chronic liver disease that causes inflammation and liver damage. Experts don’t know what causes it, but it is more likely to appear in people living with other autoimmune conditions. Certain medications can also trigger autoimmune hepatitis. -It affects more women than men. -It can lead to scarring of the liver (cirrhosis) and liver failure 2)CIRRHOGENIC DOSE OF ALCOHOL: - Time to develop Alcoholic liver disease is equal to amount of alcohol consumed -Men:60-80gm /day for 10years -Women:20-40gm /day for 10 years - Alcoholic Cirrhosis,develops only in 10-20% of those who are chronically heavy drinkers. 3) VIRAL HEPATITIS LEADING TO LIVER CIRRHOSIS: - Heaptitis A has low chances of leading to long term complications like Cirrhosi
Read more