60 years old lady compaints body pain, shortness of breath, frequently stool five to six time a day with pain.plzz suggest ur valuable opinion
CBC is normal Urine examination is normal Stool examination is normal USG - bilateral non- obstructive small renal calyceal calculi - asymptomatic ESR is raised more than 50 Pain abdomen is most likely due to Irritable bowel syndrome But other causes need to be ruled out like 1.Intestonal tuberculosis 2.Inflammatory bowel disease 3.Amoebic colitis Considering SOB and raised ESR - an X - ray chest is indicated.to rule out pulmonary tuberculosis
Hemogram suggest dimorphic anaemia Fatty liver indicates digestive problems Hence associated complaints Raised esr could a/w anaemia But i will suggest to r/o DM2T Rx correct the anaemia with inj vicofol weekly or biweekly Substitutes iron and nutritional deficiencies For frequent motions add tab normaxin 1tds Tab rifaxigyl-m 1tds Add tranquillisers at bedtime For digestive enzymes after food and tab hepamerz and vimliv for fatty liver Sos udco to be added One more problem of renal calculi so as per her complaints you can treat same conservatively or hydrotherapy or surgical intervention
Anaemia with fatty liver AND B/ L asymptomatic renal stone. IBS AND INTESTINAL TUBERCULOSIS MUST BE RULED OUT. UNDER PRESENT CIRCUMSTANCES COVID 19 MUST ALSO BE RULED OUT.
Anaemia Hepatitis Renal calculus both sides. Needs CT scan of whole abdomen. LFT, BS(F) PP, HbSAg, Urea, Creatinine, Urine C&S.. Tab. Meftalspas SOS Cap. Pantoprazole 40 mg OD Cap. Vibact DS OD SY. ENZYMES 10 ML BDPC REVIEW AFTER 7DAYS WITH INVESTIGATION REPORTS AND RULE OUT THE MANAGEMENT OF THIS PATIENT.
? ANEMIA WITH.. FATTY LIVER.. IBS.. BL..RENAL CALCULI.. NEED'S.. ANEMIA PROFILE.. LFT..KFT.. BSR HBA1C.. CXR.. ENDOSCOPY STUDY..
NEEDS ..X. RAY....CHEST.. AND U. S. G....THORAX IF. FINDINGS. ARE.. N. A. D/ W N L THEN. ..ADVISABLE... SYMPTOMATIC MANAGEMENT. FOR ... INTESTINAL. INFECTION...
send lft rft se elec and blood culture,mp,hbsag,dengue cxr IBS gastroenterology opinion
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