Bimonthly assessment(november)
CASE : 1
1) "55 year old male patient came with the complaints of Chest pain since 3 days Abdominal distension since 3 days Abdominal pain since 3 days and decreased urine output since 3days and not passed stools since 3days.
https://sreejaboga.blogspot.
A) Where are the different anatomical locations of the patient's problems and what are the different etiologic possibilities for them? Please chart out the sequence of events timeline between the manifestations of each of these problems and current outcomes.
Gallbladder,pancreas,Rt lung,kidney,thyroid.
Gall stones due to Hypertriglycerdemia
a-acute pancreatitis mostly due to gallstones .
it can be alcohol also
acute pancreatitis leads to SIRS
Bcz of SIRS exudative pleural effusion on rt side of heart.
AKI due to prerenal cause that is acute pancreatitis
usg abdomen,CXR,sr.amylase,CBP,RFT,
2D echo,TFT,ascitic tap,pt,lipid profile
B) What are the pharmacological and non pharmacological interventions used in the management of this patient and what are the efficacy of each one of them?
pharmacological intervention
a IVF
Piptaz,metrozyl-antibiotics
Tramadol-to relieve pain
Zofer-to relieve vomitings and nausea
Lasix
Nebulization with budecort
Non pharmacological intervention-
Stop the alcohol intake
Avoid fatty food
Increase the intake fiber rich food,fuits, vegetables.
Exercise for atleast 30mins .
CASE : 2
2) A 55 year old male, shepherd by occupation, presented to the OPD with the chief complaints of fever (on and off), loss of appetite, headache, body pains, generalized weakness since 2 months, cough since 2 weeks and vomitings and pain abdomen since 2 days.
https://aakansharaj.blogspot.
A) Where are the different anatomical locations of the patient's problems and what are the different etiologic possibilities for them? Please chart out the sequence of events timeline between the manifestations of each of these problems and current outcomes.
ANATOMICAL LOCATIONS WITH ETIOLOGY:
BONE MARROW
Etiology: Multiple myeloma
KIDNEYS
Etiology: AKI due to multiple myeloma
HEMATOLOGICAL (ANEMIA)
Etiology: secondary to multiple myeloma
LUNGS
Etiology: Tuberculosis (Increased susceptibility to infections)
B) What are the pharmacological and non pharmacological interventions used in the management of this patient and what are the efficacy of each one of them?
PHARMACOLOGIC :
1.ANTIBIOTICS : For underlying infection (Azithromycin for ?Atypical pneumonia)
2.ATT : For TB
3.SEVELAMER : For hyperphosphatemia
4.FEBUXOSTAT : For hyperuricemia
5.PRBC transfusion for anemia
CASE : 3
3) 51 Year old man with complaints of B/L pitting pedal edema from 5 to 6months,abdominal distension from 2 to 3 days,SOB from 3days.
nithishaavula.blogspot.com/
A) Where are the different anatomical locations of the patient's problems and what are the different etiologic possibilities for them? Please chart out the sequence of events timeline between the manifestations of each of these problems and current outcomes.
ANATOMICAL LOCATIONS WITH ETIOLOGY:
HEART (HFrEF - pedal edema , abdominal distention and SOB) :
Etiology: Microvascular dysfunction DM and HTN
CNS (Seizures)
B) What are the pharmacological and non pharmacological interventions used in the management of this patient and what are the efficacy of each one of them?
Pharmacological interventions
meta analysis with each class of drugs)
Preload reducers
Diuretics
Afterload reducers-ace inhibitors
Rate controlling agents-beta blockers
Antiepileptics for known case of epilepsy
Insulin for glycemic control in diabetes.
Non pharmacological interventions:
Salt and fluid restriction
Individualized salt and fluid restriction can improve signs and symptoms of CHF with no negative effects on thirst, appetite, or QoL in patients with moderate to severe CHF and previous signs of fluid retention
CASE : 4
4) 31 yr old man with B/L pedal edema with scrotal and penile swelling since 2 months
https://nairaditya97.blogspot.
A) Where are the different anatomical locations of the patient's problems and what are the different etiologic possibilities for them? Please chart out the sequence of events timeline between the manifestations of each of these problems and current outcomes.
ANATOMICAL LOCATIONS WITH ETIOLOGY:
HEART FAILURE (pedal edema , penile & scrotal swelling and SOB) :
Etiology: Alcohol causing wet beriberi
AXONAL SENSORY POLYNEUROPATHY:
Etiology: Alcohol
B) What are the pharmacological and non pharmacological interventions used in the management of this patient and what are the efficacy of each one of them?
pharmacological interventions:
Diuretics
Thiamine
non pharmacological interventions:
Salt and fluid restriction
