45yrs F c/o pain Abd with vomiting & black stool, burning sensation in stomach & hunger pains, body ache. UGIE normal, stool OB negative, Urinalysis normal. Other reports attached. Dx & Tt?

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This patient is anaemic .Hb 9.3 gm.So we can explain every thing with anaemia.Bodyaches due to anaemia itself.Maybe she has been given some iron preparation. That will cause dark stools and at the same time burning sensation in stomach and may be vomiting also.However should get u/s abdomen and barium follow through study along with coagulation profile. In the meantime give PPIs, keep NBM.

USG report attached. Was not taking any Hematinic prior to the start of complain.
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I will treat this pt simply of chr gastritis mild increase of tsh do suggest hypothyroidism but doesn't co relate to presenting complains usg suggesting calculus and mild cystitis black colored stools need further workout as absenceof occult blood gives some relief yes pt is anaemic so work on anaemia should help simple def of vitb12 may be aggravating factor pt gets hunger pains so frequent meals with ppis and antacids should relieve.

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Pt is suffuring from Anaemia,Renal Calculus ,& Having low platelet counts Rx Inj GNS 500ml IV Slowly+ Inj Ranitidin 1amp IV in Drip + Inj Cefotaxim 1gm IV in drip + Inj B Complex 1 Amp IV in drip , for 3days & Syp Antacid 2tsf bd Tab Cefexim 200mg 1bd & Tab Iron Folic acid 1od for 10 day's

Mildly elevated TSH Possibility of cystitis /uti Get x ray fpa Start low dose thyroxin Laxative Ppi and appropriate antibiotic Along with antidepressant May be she respond well If not Get cect, colonoscopy, urine prophyrin

Hypothyroidism mild ,Acute Gastritis, renal calculus Rx Iv fluids Iv antibiotics Iv pantoprazole Iv Buscopan Wait n watch to start THYRONORM so repeat TSH AFTER 3 MONTH

Acute porphyria should be considered in the differential diagnosis.

UGI Infection neeAntacids Antiemetic pan upper GI endoscopy inj.Botropase. Smooth Muscle Relaxants other Symptomatics treatment

Ooks to be ACID PEPTIC DISEASE.RULE OUT ULCER STOMACH HAVE SECOND OPINION.TAKE AMTI ACIDS.GEL.OMPERAZOL LIGHT BLAND DIET.NO HOT OR SPICY FOOD. NO JUNK FOOD OR COLD DRINKS

D/D Duodenal Ulcer. ADV. Endoscopic evaluation.

UGIE normal
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