55F Diabetes hypertension 6 years, DKA, Fever, Cough since 3 weeks

55F Patient came to opd with c/o

1. Fever since 3 weeks

2. Cough since 3 weeks

Patient was apparently asymptomatic 3 months back then she developed fever, insidious, progressive, no diurnal variation, low grade not associated with chills and rigors.

C/o cough - dry, not associated with sputum, more during the nights and increased in supine position.

No case of burning micturition, decreased urine output.

H/o polyuria and nocturia

C/o decreased appetite

No C/o SoB/ palpitations/ chest pain/ orthopnea

Past History:-

K/C/O HTN since 6 yrs, and is on unknown regular medication

K/C/O DM2 since 4 yrs, and is on Tab. Voglibose 0.2mg PO/BD

Personal History:

Appetite- Normal

Diet- Mixed

Sleep- Adequate

Bladder and Bowel movement- Regular

Addictions - none

Family History: not significant

GENERAL EXAMINATION:-

The patient was examined in well lit room after taking her consent.

The patient was conscious, coherent and co operative. She is well oriented to time, place and person

No Pallor, Icterus, Cyanosis, Clubbing, Lymphadenopathy. Edema present (Pitting type)

On examination:-

BP- 140/90

Temp- 97.2F

Pulse- 86 BPM

RR- 16

SpO2- 98

Investigations:

13-10-2023

14-10-2023

Montaux test was done-

Comments

43F Patient came to opd with c/o Bilateral pedal edema

This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. 43F Patient came to opd with c/o Bilateral pedal edema since 1 month. Patient was apparently asymptomatic till 1 month ago then she developed c/o B/L pedal edema (pitting type, extending upto the knee) and chest discomfort (now subsided) now patient has c/o tingling of Rt. Upper limb. Pt has come for regular checkup of HTN& DM Had H/o UTI 1 month ago Numbness in Rt upper limb and Rt lower limb since 1 month. PAST HISTORY:k/c/o Diabetes since 10 yrs and is on Insulin HAI 15U- 20U- 25U. k/c/o hypothyroidism since 6 yrs and is on Tab. Thyroxine 125mg PO/OD k/c/o Hypertension since 2

A 50M with C/o Bilateral Pedal Edema

A 50Y M Came with C/o Pedal Edema since 1 week HOPI:- Patient was apparently asymptomatic 1 Year back then he developed back pain for which he went to local hospital and diagnosed to have CKD. He was on Conservative management, 3 months back he had Pedal edema and started on hemodialysis since May 25 which was his last follow up. Pedal edema is present Blood transfusion of PRBC done on 02/09/23 Dialysis was done on:- 21/8/2023 24/8/2023 30/8/2023 02/9/2023 04/9/2023 23/9/2023 27/9/2023 30/9/2023 02/10/2023 07/10/2023 Past History: K/C/O CKD since March 2023 K/C/O DM2 since 4 years on Insulin ( Irregular Medication) K/C/O HTN, CVA, CAD, Epilepsy Surgical history:- 4 years back 2nd right toe amputation done (Diabetic) In March RIGHT IJV was placed and removed in May. On Examination:- Patient was conscious, coherent and cooperative No signs of Pallor, Icterus, Cyanosis, Clubbing, Lymphadenopathy Vitals:- Temp- 98.4F PR- 96 BPM RR- 18 CPM

A 70 YR OLD MALE WITH ALTERED SENSORIUM AND HYPONATREMIA.

This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome." CASE: A 70 year old male came with chief complaints of : 1) Altered behaviour since afternoon. 2) Involuntary movements of the both upper limbs and lower limbs since 4pm along with loss of speech and involuntary movements of the mouth. HOPI: Patient was a security guard by occupation in Hyderabad 20 years back and there sons brought him to their village 20 years back and was doing nothing since then. He was normal till 1 month back and started developing decr

171 MK Farhan, E Log Cases

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