37 year old female patient.. C/o uneasy sensations on left chest Region followed by irregular bowl movements (loose motion).not able to sleep.. Restlessness.. . Xerostomia also.. Since 7 days... Ecg normal.. Bp normal.. Pulse slightly high...gen body weakness.. History of migraine.. Familial history of coronary heart disease.. Pt felt better after taking omeprazole and metoprolol tab @Kindly suggest the dignosis and treatment In blood investigation.. Pts vita b12 or vita D3 =7 is low Hb, rbc count, lymphocytes on slightly high Non hdl cholesterol is 134 /high

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Patient needs,evaluation before arriving at a Diagnosis. . Get a TMT , Echocardiography and holter monitoring along with a lipid profile considering a family history of coronary heart disease. Also get a thyroid profile done to rule out hyperthyroidism. Considering- tachycardia, xerostomia , and other symptoms- a provisional Diagnosis of Anxiety disorder can be made A PPI and etizolam 0.25 mg meanwhile can be started

Sir.. @Kindly suggest the dignosis and treatment In blood investigation.. Pts vita b12 or vita D3 =7 is low Hb, rbc count, lymphocytes on slightly high Non hdl cholesterol is 134 /high
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Prolonged loose motions with xerostomia weakness uneasy sensations loss of sleep These all symptoms point to hyperthyrodism and need to be investigated and treated Needs to evaluate electrolytes imbalance and to be corrected TFT to see hyperthyrodism You said relieved by metaprolol points again hyperthyrodism if she is nonhypertensive F/h of CAD needs to be screened

Thanx dr Dinesh Gupta
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1 UNEASY SENSATION LEFT CHEST ------> LOOSE STOOL 2 INSOMNIA 3 RESTLESS 4 DRY MOUTH ECG NORMAL NORMOYENSIVE TACHYCARDIA KCO = MIGRAINE F / H = CAD TREATMENT = OMEPRAZOLE METOPROLOL BECAME BETTER PAINCHEST = SITE RETROSTERNAL ? PRECORDIAL ? 1 SUBMAMMARY PAIN ? . FOLLED BY LOOSE STOOL = GASTROENTERITIS NOT A CASE OF CAD 2 TACHYCARDIA DRYNESS OF MOUTH POSSIBLY DUE TO FLUID LOSS DUE TO DIARRHOEA 3 INSOMNIA RESTLESSNESS MAY BE DUE TO AN 4 OMIPRAZOLE = A PPI MAY NOT BE GIVEN WHEN THERE IS DIARRHOEA AS PPI CAN CAUSE DIARRHOEA THIS IS NOT WAY OF PRESANTATION OF CA D I SHAL ADVICE HER BLOOD ELECTROLYTES FLUID REPLACEMENT PO / IV DEPENDING ON CLINICAL STATUS

I agree
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Suspected irritable Bowel Syndrome DD Sjogren's syndrome Give fiber in diet, antidiarrhoeal,and antistress medicine. Lotronex , rifaximin ,amitiza etc can be used

Generalised Anxiety Disorder . To rule out Hyperthyroidism, by doing thyroid profile

Sir... @Kindly suggest the dignosis and treatment In blood investigation.. Pts vita b12 or vita D3 =7 is low Hb, rbc count, lymphocytes on slightly high Non hdl cholesterol is 134 /high
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Anxiety Neurosis

POSSIBLY.. ...i. B. S.. And HTN. With A. N

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