60 yr male with viral pneumonia, ? AKI

-

A 60 yr old male farmer by occupation, resident of narketpally came to the casuality 
with chief complaints of dry cough, sob since 3 days and fever since 1 day.


Hopi: patient was apparently asymtomatic 3days back then he had dry cough, progressive in nature not associated with any diurnal/ postural variation.

sob initially grade -II gradually progressed to grade-IV. 
not associated with any PND,orthopnea, pedal edema.
from day 1 patient is having fever, low grade, intermittent, not associated with chills and rigors, relieves on taking medication.

No h/o any decreased urine output.


Past history: 
no H/o of diabetes hypertension,asthma,TB, epilepsy

Genral examination:
pt is c/c/c, 
afebrile.
BP-140/80, 
pr-104, 
sats-89(at 15L of o2)

Diagnosis: Viral pneumonia with type 1 respiratory failure with AKI

Clinical pictures:-




Treatment:-

1. O2 inhalation to maintain spO2 >92%
2. IVF NS, RL @75 mL/ hr
3. Inj. ceftriaxone 1gm iv/bd
4. Tab. AZITHROMYCIN 500 mg po/od
5. Inj. Pan 40 mg iv /od
6. Inj thiamine 1 ampoule in 100 ml ns iv/bd
7. Nebulisation with duolin 12th hrly, budecort 8th hrly 
8. Inj LASIX 20 mg iv/bd
9. Tab. Atoz po/od
10. Strict i/o charting
11. Temp charting 4th hrly 
12. Intermittent BiPAP for 30 min every 6th hrly

Comments

Post a Comment

Popular posts from this blog

PARAPARESIS OF THE LOWER LIMBS SECONDARY TO TB

-
Paraparesis of the lower limbs. Hello all, I am P.Vihar (Roll no 127) a student of 8th semester pursuing medicine at KIMS Narketpalli. Today I share, in this blog  my views and thoughts on a case   which our department of general medicine has shared, to help us achieve better understanding of the clinical cases. The link given below, is to the entire case details :- https://vaish7.blogspot.com/2020/05/medicine.html?m=1 MY VIEWS AND THOUGHTS ON THIS CASE. Here we see a 23 year old male patient with history of a sudden fall when he tried to get up to use the bathroom. Patient came to the hospital in this regard complaining of weakness in both lower limbs. After going through his history i have some questions in mind which i will write down below:- 1) His chief complaint was tingling and numbness in both lower limbs since 5 days. This makes me think of paresthesia in his legs, but when we talk about paresthesia there are many causes like herniated disc, tumor in the spinal cord, etc.. al
Read more

2023 (November) JRCPTB QIP Project Cycle - 3 Presentation.

-
Image
Inpatient care Quality Improvement Project.   The Inpatient care quality improvement cycle started with the goal of improving patient care by identifying lapses, and checking progress in 4 domains of clinical practice that impact the quality of inpatient care namely;    ·        History taking  ·        Clinical/ physical examination ·        Lab and imaging data analysis ·        Full case analysis   Using the online learning portfolios of the students of 2016 batch; which was divided into 4 quarters; these 4 domains were graded based on performance from 0-4. I collected this raw data and processed the data to represent it statistically (quarter mean and cumulative mean scores). Thus enabling us to check for progress/ changes in specific domains and overall clinical practice.   After processing the data, I systematically entered the data into an excel spreadsheet and made relevant tables/ graphs to represent our findings.  These online learning portfolios were selected for cycle 3. T
Read more

80 yr male

-
 80 yrs old Male came to casualty with  C/O loss of consciousness (for half an hour) C/O involuntary bowel and bladder incontinence and slurred speech since 4am today(19/12/21) HOPI Patient was apparently asymptomatic till 4:00am today got up from bed and walked to washroom ,while walking near the door at 4:00am,patient slipped and fell on the ground-sustained injury to back and head. He had loss of consciousness for half an hour and then regained.Conscious spontaneous with no involuntary movements,froth from mouth. H/O involuntary micturition and defecation present  H/O slurred speech present after fall On presentation patient is conscious,confused,slurred speech present. Past history  N/K/C/O HTN,DM,TB,epilepsy,CVA,CAD Personal history  Diet -mixed Appetite-normal Bowel movements-irregular  He is a toddy drinker and smokes chutta  Family history  Not significant  General examination  Pt is conscious  Vitals Temp-Afebrile  Bp-120/60mmHg PR-90bpm Spo2-99% on RA Systemic examination  CV
Read more