202306475

 


Case History and Clinical Findings

PATIENT WAS BROUGHT TO CASUALITY BY HER ATTENDER IN A STAGE OF UNRESPONSIVE TODAY MORNING.

PATIENT WAS APPARENTLY NORMAL 2MONTHS BACK THEN SHE DEVELOPED FEVER LOW GRADE ON AND OFF,INTERMITTENT,SOME TIME ASSOCIATED WITH CHILLS AND RIGORS, NO DIURNAL VARIATION NOT WITH COUGH,COLD ,BURNING MICTURITION + WHICH WAS RELEVED WITH MEDICATION.THEN TODAY MORNING PATIENT TOOK ORAL HYPOGLYCEMIC TABLET 10 MINUTED BEFORE CONSUMPTION OF FOOD AND HAD BREAKFAST AND SAT

,SUDDENLY SHE BECAME UNCONSCIOUS,ON ARRIVING HOSPITAL HER GCS WAS E1V1M1. PAST ILLNESS:

K/C/O HTN SINCE 5 YEARS :ON UNKNOWN MEDICATION K/C/O DM 2 SINCE 2 MONTHS:ON UNKNOWN MEDICATION PATIENT IS CONSCIOUS COHERENT, COOPERATIVE

 

NO PALLOR,NO ICTERUS, NO CYANOSIS,NO CLUBBING,NO LYMPHADENOPATHY, PEDAL EDEMA

BP- 110/70MMHG PR- 76BPM

RR- 20CPM SPO2- 98% @RA

CVS- S1 S2 HEARD

RS- BILATERAL AIR ENTRY PRESENT + P/A- SOFT NON TENDER

CNS- NO FOCAL NEUROLOGICAL DEFICIT

Investigation

HEMOGRAM,LFT,SR UREA,SERUM CREATINE,SERUM ELECTROLYTES,FBS,PLBS HBA1C

Treatment Given(Enter only Generic Name)

1) IVF NS AND RL @75ML/HORLY

2) GRBS MONITORING 4TH HOURLY

3) BP,PR RR MONITORING 4 TH HOURLY

4) INFORM SOS

5 WITH HOLD OHA.

6) TAB METFORMIN 500MG PO/OD 8AM

7) TAB GLIMIPERIDE 1MG PO/OD 8AM

9)TAB CINOD 10MG PO/OD 8AM

Advice at Discharge

1) TAB METFORMIN 500MG PO/OD 8AM

2) TAB GLIMIPERIDE 1MG PO/OD 8AM

3) TAB CINOD 10MG PO/OD 8AM


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