a 27 yr female , SOB grade 4 since 5 days,her hb is 6.7gms ,b/l pedal. edema, 2d echo was EF 45% ,RF positive, ESR 70 1st hour ,now she is on O2 inhalation through mask 3 lit,inj piptaz 4.5 gr and inj moxiflox,inj dexamethasone,inj pan 40, any modifications regarding medication and management, advised 2units PRBC,pleural taping was unsuccessful,??? thankyou

Pulmonary Hypertension with BVF. *Chief Complaints* A 46 yr old female attended Mopd with progressive SOB and productive cough since 1 month with pedal edema since 10 days. No associated fever,chest pain,palpitation,Hemoptysis,Diaphoresis,pain abdomen etc. She is K/C/O Hypothyroidism and Br Asthma. No H/O HTN,DM,Substance abuse. Normal Menstrual Cycle. General Examination normal except B/l pedal edema and prominent Neck veins. Systemic Examination- B/l Infrascapular fine crepts with occasional Ronchi. Routine Ix was advised. Pt attended Mopd with reports showing- CXR - increased CT ratio suggestive of Cardiomegaly with b/l lower zone opacity. Sputum C/S normal flora. Rest blood Ix normal. ECG - multiple VPCs. 2D ECHO- 1. LV function is mildly depressed with estimated LVEF of 45%. 2. IVS and apex are mildly hypokinetic. 3. Right Atrium & Left Atrium are dilated. 4. Right Ventricle is dilated. 5. Moderate Tricuspid Regurgitation. 6. Severe pulmonary hypertension with calculated RVSP of 65mmHg +RAP. 7. Mild Mitral Regurgitation, 8. Trivial Aortic Regurgitation. 9. No LA/LV clot or pericardial effusion. NT Pro BNP not done. Pt started on conservative treatment.

27 year old female , recently diagnosed with bronchial asthma and 8 months amenorrhea post delivery , presented to ER with sudden onset of grade 4 SOB today morning at 11:00 am with profuse sweating and abdominal discomfort , patient was apparently asymptotic till then Had h/o dry cough since 2 months No h/o vomitings, chest pain , giddiness ,loose stools , decreased urine output ,burning micturition One episode of bleeding per rectum in hospital On arrival Pt -Drowsy,arousable GCS-E3V4M6 Bp-100/60 HR-123/min Grbs-33 Mgdl Chest -Bae , mild wheeze Laboured breathing pattern CVS-s1s2 heard Spo2-98% on room air Cold peripherals with feeble peripheral pulses Advised for CBP,ABG, electrolytes, RFT, urine for ketones, CXR,ECG CBP- HB-13.2,RBC-4.4,wbc-8300,platelet-41000 Electrolytes ,urea & creat in normal range ABG- Ph 6.994,pCO2 10.9, pO2 120.6, HCO3act 2.6 mol/l ,HCO3std 7.2mmol/l UPT is negative Viral markets are negative Couldn’t get Ketones as there is no urine output for patient since morning

57 yr old female.admitted in ICU day three Case of dilated cardiomyopathy with EF 30. O/e b/l wheeze,(now subsided) Vitals stable. PT on Bipap repeated ABG posted below... Ur advice on the case pls/!!! And comments on ABG...

42M,progressive cough,dyspnea gr4,since 8days, travelled to kerala recently.spo2 84%on nasal 02.HR130,BP110/60,newly ムT2DM.whats possible diagnosis and treatment?