68/Female present with severe dyspnoea known case of Bronchial Asthma ,HTN, Hypothyroidism on Medictation. Started on Nebulisation, Augmentin, Hydrocortisone, Syp Pulmoclear , Ecosprine Av, Storvas 40, Amlong 5mg BP:180/90 PULSE 86/Min Spo2 88% RA Attached Xray

68 yr old lady known case of DM, HTN, Asthma on various medications, glimi, metformin, insulin, telimsart H 40 also Dytor developed sudden weakness and easy fatiguity.. She had fever and weight gain of 5 kilos.. she has pedal edema.. BP sugar normal.. Spo2 89, basal creptations seen.. covid neg, ecg tachycardia.. Chest X-ray shows pnemonia.. no cardiomegaly.. Started with antibiotics and supportive Treatment.. My diagnosis is pnemonia, but what's the reason for her pedal edema and breathless.. she is a known case of bronchial Asthma.. I m confused how to differentiate in this case between cardiac and bronchial Asthma..?? Known case of bronchial Asthma, but y crepitation in lungs, pedal edema, swearing, low saturation..?? How to manage this case further..??

age 70yrs c/0-sweting ,giddiness ,fever with chills no chest pain ,vomitting k/c/o- Htn from 15 yrs. bp-130/70mm of hg p-80/min.Spo2- 97% BSL- 88MG /DL

51 yr k/c/o bronchial asthma fever for 7 days hemoptysis 1 episode tlc 12000 E 7% xray and CT attached

18022018 NICU 1 Refferd case 2.5 month male 5.5 kg Admitted with c/o tachypnea dyspnea SCR+nt abdominal distension O/E RR 68 bmp PR 164 bpm SpO2 79% off O2 P/A distended soft with hepatomegalae(+4 cm Urine passed Stool passed Temp Afebrile Pallor +nt Refferal history 15 days before asymptomatic then noisy breathing with tachypnea present admitted in another hospital with inj pipzo,amika and discharged with syp linezolid After 1 day of discharge remision of symptoms occured admitted again for 7 days with inj vanco,amika,azithro,meropenem,linezolid and pipzo CTthorax suggestive of multiple consolidation 18/02/2018 8 am Pt is on vent with SIMV/28 bpm/40%/5cm H2O SpO2 97% PR 182 bpm RR 58 bpm(on disconnecting vent with very much sCR) Reports attached( note:digital x ray is older than normal one) What could be the causetive organism (CMV??Pulm koch?) What may be role of surfactant in this case? Kindly comment your valuable opinion Our ddx bronchopneumonia vs pulm koch with septicemia 19/02/2018 Disconnected vent but not maintaining PR 164 bpm RR 70 bmp SPO2 74% P/A distended soft with liver +4 cm Temp afebrile 1.which vent mode is best for such a case in with baby is tachypnic hypoxic poor activity with exessive SCR+nt...SIMV or AC 20/02/2018 Inj fluconazole and ATT started since the day of baby arrival ...baby is on vent so unable to nebulise with tobramycin(for suspected pseudomonas infection ....culture of a blocked ETT sent yesterday) exessive drooling was present so iadded glycopyrolate 0.1 ml iv 8 hrly Baby was placed on vent CPAP yesterday20/02/2018 since morning but suddenly at 4 pm baby held his breath f/b gasping and cynosis hypoxia(what could be the cause ...antibiotics? )