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Showing posts from January, 2021

Bimonthly assessment January

a)  Problem representation : 26yr old female with k/c/o SLE Polyarthritis with head ache since 8 days and fever, vomtings since 4 days and altered sensorium since 2 days with Euvolemic hyponatremia under evaluation. Anatomical localization: Brain. b) etiology: CVA , TB Meningitis , SLE vasculitis ,SIADH secondary to infection.    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357611/( Bisphosphonate prophylaxis). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970554/(proton pump for corticosteroid ulcers) https://pubmed.ncbi.nlm.nih.gov/10067053/ ( TB Meningitis in SLE pts) C) Bisphosphonates were given to prevent osteoporotic fracture risk associated with using long-term steroids. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357611/ Bisphosphonate prophylaxi s d) Probable cause of normal CSF count in patients of Chronic meningitis is probably due to the use of steroids which caused immunosuppression and decreased inflammatory   was the research question in the a...

26 m btech with complaints of vomitings

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  26/M btech,completed 3yrs back non alcoholic and a non smoker , developed vomitings 4-5episodes on23rd December: yellow colored,non bilious,non blood stained contained foodparticles/water. Thenafter patient used to have vomitings every day 2-3episodes or at times multiple episodes for  one &half month i.e till feb 11th    After 15days of onset of vomitings i.e in January patient went to Suryapet hospital and there for the first time he was said to have high bp-170mmhg and brain imaging was done .Used anti hypertensive drugs for 10days and stopped On February 12th he presented with : 1-multiple episodes of vomitings a day before,2-he noticed decreased urine output since January  3- intermittent shortness of breath on walking for long distance 4-spasm of both calves since 5-6yrs monthly twice/thrice only night times due to which he used to get up from his sleep His creatinine was 15mg/dl On February 13th he was referred to NIMS  i/v/o renal biopsy.There...