55 YEAR OLD MALE WITH C/O FEVER AND SOB

MEDICAL CASE

This is an E log book to discuss our patient's de-identified health data shared after taking his guardian's signed informed consent. Here we discuss our individual patient 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 comments in comment box are most welcomed 

I have been given this case to solve in an attempt to understand the topic of "Patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan.  

CASE DISCUSSION:

A 55 year old male came with chief complaint of

  • FEVER SINCE 3 days
  • SOB SINCE MORNING 
HOPI:

Patient was apparently asymptomatic 10 years back 

EVENT TIME LINE: 




PAST HISTORY:

k/c/o DM since 10yrs on medication GLIZED 80 (sulfonylurea) 

k/c/o HTN since 7yrs on medication NICARDIA 30mg

K/c/o CKD ON MHD since 3 months 

Last session of dialysis on 1/10/22

PERSONAL HISTORY:

He is a contractor by occupation 

Consumes mixed diet

Appetite normal

Bowel n bladder regular 

Sleep adequate 

Addictions: Used to consume alcohol since 30 years- occasionally but stopped 6yrs back due to family pressure 

FAMILY HISTORY:

No similar complaints in family 

CLINICAL IMAGES:









GENERAL EXAMINATION:

Pt is conscious, coherent and cooperative 

Moderately built and nourished.

On admission:

BP:140/80mmhg

PR:146bpm

RR:24cpm

SPO2: 90% on RA

GRBS: 163mg/dl


SYSTEMIC EXAMINATION:

CVS: S1,S2, +

RS: BAE+

P/A: soft, non tender 

CNS: NAD


PROVISIONAL DIAGNOSIS: 

SOB UNDER EVALUATION 

K/c/o CKD ON MHD since 3 months 

INVESTIGATIONS:





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