54 yr old male pt with status epilepticus,Hypokalemia,hypoproteinemia,diabeties with microvascular complications

54 yr old male pt came with
Complaints of fever from 6 days
Complaints of seizure from  yesterday

Patient was apparently asymptomatic 6 days back then he developed a fever for 2 days which was low grade ,intermittent and associated with chills and relieved on medication, patient was normal up to 2 days till Monday night then he developed involuntary movements of upper and lower limb and associated with tongue bite . patient was taken to private hospital [up To 8 episodes] of seizures happened till next day morning, then patient was taken to government hospital where  CT was done then he had 5 more episodes of seizures within 2 days and was referred to KIMS for the furture evaluation
K/c/o DM since 15 yrs and on TAB.METFORMIN 500MG and TAB GLIMIPIRIDE
K/c/o HTN since 3 yrs and on medication TAB.ATENOLOL 50MG
Alcohol occasionally
somker [stopped 20yrs back]
O/E
pt is conscious coherent cooperative 

Temp-afebril
PR-79bpm
BP-130/90 mmHg
spo2-97%at room air
GRBS-335 mg/dl
Systemic Examination
cvs-s1,s2+
Rs-BAE+
p/A-soft non tender 
GCS:-EV5M5
-CVS 
Higher Mental functions-Normal
Cranial nerves-NAD
motor system-.                    R.                      L.   
power                  UL-.          5/5.              5/5.    
                             LL-.           4/5.              4/5.  
 Tone-.                 UL-.        normal         normal
                             LL-.         normal          normal
reflexes-.                                   R.                      L.   
                 biceps-.                     1+.                   1+.  
                 triceps-.                    1+                     1+
                 supinator-.                1+                    1+
                 knee.                         1+                    1+
                 ankle-.                       1+                    1+
                 plantar -               flexion              flexion 
sensory system- intact
Cerebellar functions test
finger nose test normal
knee heal test -normal
gait

Popular posts from this blog

46 yr old male with HFrEF with type 4 cardi renal symdrom with DCMP with ischemic Hepatits

Image
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. Team: Interns- M Supriya Mohitha K Sowmya Sanjay Amrutha Dr.Druga Krishna PGY1 Dr.Ajith Kumar PGY2 Dr.Laxma Reddy PGY3 Dr.Manasa PGY3 Dr.Vijaya Lakshmi (Ast.Prof.) 46 years old old male patient came with  c/o abdominal distension since 20 days   c/o shortness of breath since 20 days and c/o  pedal edema since 20  days Patient was apparently asymptomatic 6 years back then had  throne pricking on the left foot followed which he developed swelling of the left foot for wh
Read more

50 yrs old male k/c/o HbsAg +ve with cirrhosis

Image
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. Team: Interns- M Supriya Mohitha K Sowmya Sanjay Amrutha Dr.Druga Krishna PGY1 Dr.Ajith Kumar PGY2 Dr.Laxma Reddy PGY3 Dr.Manasa PGY3 Dr.Vijaya Lakshmi (Ast.Prof.) A 50 year old male came with c/o distention of abdomen since 7 months,B/L pedal edema since 7 months,  pt was apparently asymptomatic 7 months back then he developed  low grade fever with yellowish discolouration of eyes followed by pedal edema  which is gradually progressive and pitting type -no aggrevating
Read more

BIMONTHLY EXAM

Image
FEBRUARY BIMONTHLY EXAM Questions: Q.1) Please go through the patient data in the links below and answer the following questions: 50 year man, he presented with the complaints of Frequently walking into objects along with frequent falls since 1.5 years Drooping of eyelids since 1.5 years Involuntary movements of hands since 1.5 years  Talking to self since 1.5 years  More here: https://archanareddy07.blogspot.com/2021/02/50m-with-parkinsonism.html?m=1 Case presentation links:  https://youtu.be/kMrD662wRIQ a). What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings? problem presentation: drooping of eyelids since 8 to 9 months refractory to treatment involuntary movements of bilateral upper limbs frequent episodes of fatigue since one year thin stream of urine with bed wetting since one year according to attenders  change in behavior (talking to self) since 1.5 years anatomical localisation of lesi
Read more