pyrexia

A 24yr old female patient came to the OPD with chief complaints of fever since  10 days and cough since two days 

HOPI

Patient was apparently asymptomatic 10 days ago then developed high grade fever with chills and rigors which was continuous type and relieved. Temporarily on IV medication. Fever is mainly during the night time. It is associated with headache, generalised weakness and abdominal pain after having food.

Then developed dry cough since two days occasionally which resolves spontaneously 

No c/o Rash retro orbital pain, cold vomiting, loose stools burning micturation, 

no bleeding manifestations 

No c/o chest pain, SOB ,Palpitations  decreased urine output orthopnea ,PND 

Past History 

H/o appendicectomy

N/K/C/O HTN, DM ,CAD, seizures TB,seizures, asthma 

Personal history

Mixed diet 

appetite-normal 

Bowel and bladder- regular 

General examination 

Patient was conscious coherent, cooperative

Not adequately built and  nourished

Sign of Pallor present.                                      No signs of cyanosis clubbing lymphadenopathy , edema

Fever Charting

25th and 26-10-23


Systemic examination 

C V S-S1 and S2 heard no murmurs.              RS- NVBS heard                                                       trachea is central 

Abdomen- No tenderness, No bruit heard 


INVESTIGATIONS

Provisional diagnosis :-                                 Viral Pyrexia with thrombocytopenia 


Treatment

25/10/23

IV fluids -NS -@100ml/hr

    Inj.Neomol 1gm IV/SOS 

Tab.PCM 650mg PO QID

Monitor vitals every 4th hrly


26/10/23

IV fluids -NS -@100ml/hr

    Inj.Neomol 1gm IV/SOS 

Tab.PCM 650mg PO QID

Comments

Post a Comment

Popular posts from this blog

FORMATIVE ASSESSMENT

  GENERAL MEDICINE BIMONTLY BLENDED ASSESSMENT - JULY 2021 I, B.VAISHNAVI, student of 3rd semester holding roll no. 22  was given the following formative assessment to facilitate connections between different systems or disciplines of knowledge or learning in healthcare which is purely reflecting the theme" scholarship of integration in medical education and research" You can go through the below link for assessment questions http://medicinedepartment.blogspot.com/2021/07/medicine-paper-for-july-2021-bimonthly.html?m=1 QUESTION -1 Here's my review to the following cases. Go  through it! http://medicinedepartment.blogspot.com/2021/07/2019-batch-medicine-department-online.html?m=1 Here is the link of my friend's assessment. Go through it! https://varshitha039.blogspot.com/2021/07/formative-assessment.html CASE-1 What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is t
Read more

Case discussion

Image
  B.VAISHNAVI 3RD SEMESTER ROLL NO. 22 This is an online E log platform to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. I have been given this case in order to solve in an attempt to understand the topic of patient's clinical data analysis to develop my competency in reading and comprehending clinical data and come up with a diagnosis and treatment plan. A 45 year old female farmer by occupation presented with chief complaints of abdominal pain and vomiting since 4 days, headache since 1 day.  HISTORY OF PRESENTING ILLNESS: Patient was apparently asymptomatic 5 days back. On Wednesday around 7:30 pm, pt alleged to be bitten by snake on right foot went to the local hospital, she is fine for 1 day. Had  swelling of right lower limb, went to the local hospital ( ointment  given)swelling subsided.  Complained of vomiting(2-3 episodes), bilious ( food as content) since 4 days. Pt complained  of abdominal pain si
Read more

general medicine case presentation

Image
40 yr old male patient who is daily wage labourer by occupation came to OPD with Chief complaint of pain abdomen since 5 days associated with fever since 2 days  HOPI Patient was apparently asymptomatic 5 days ago then he developed pain which is insidious in onset and gradually progressive which is  diffuse , squeezing  type and radiating to back . Pain is relieved on medication . No C/O of vomitings , loose stools , burning micturition ,cough,cold , chest pain , SOB  Past history:- N/K/C/O TB , hypertension, diabetes, Asthma, epilepsy , CAD, thyroid disorders . Personal hisrory:- Diet - mixed  Appetite- normal Bowel and bladder -regular Sleep - adequate Addictions - regular alcohol  intake of 250 ml per day  since 20 yrs . No food allergies and drug allergies General examination:- Pallor - yes  Edema -absent  Clubbing - absent  Lymphadenopathy - absent  Icterus - absent  Cyanosis absent  Vitals:- Temperature - 100.1F BP-85/60 Spo2- 98% RR-20pm PR- 100/min Systemic examination:- Per ab
Read more