70 yrs old presented with dyspnea bilateral pedal edema raised jvp Known case of asthma on inhalers Total count 18000 Bp160/90 Treated as acute asthma Ecg shows p pulmonale Tdy out put is decreased to 500ml ???Sepsis/rvf/ccf// Plz comment on xray !!!

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Xray chest:- mild cardiomegaly with perihilar haziness ? Pneumonia with COPD-COR PULMONALE. PLEASE RX:- DIURETICS(DYtor(10/50) plus tds Antibiotics (Inj.acuclav 1.2gm TDs, tab.Azee 500mg bd/AC, inj.Monocef 1gm iv bd, inj.Levoflox 100ml iv od, inj.Metrogyl 100ml iv tds. To start Digoxin (Lanoxin) 0.25microgm 2 tablets stat then 1 od Nebulization Inj.Dexona+inj deryphyllin iv TDs Inj.DYtor stat Inj.Pan 40 iv bd Inj.Perinorm iv tds And symptomatic treatment also given as required. Dr Gopi Saharan

Awesome sir...beautiful explaination...Thanku sir
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CXR. Emphasemtus chest. COPD .PT. have Bronchial Asthma. Cardiomegaly. JVP raised due Rt.heart failure. Pedal edema are also due to Rt. Heart Failure. And is Pt. Taking CCB ? AND OF.IS Renal failure also( CKD ) Prognosis is poor

Thanku sirji... awesome explaination
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This is a case of multiple organ failure starting with lungs (chronic asthma with bronchitis and emphysema) leading to classic right sided cardiac failure and presently with Acute renal failure with likely development of more fluid retention.

Thanku sir
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X.ray is suggestive of COPD. Clinical findings suggest rvf. ?Tc 18000 . Support ventilation if necessary. Do abg and treat accordingly. Evaluate CVS and do the needful

Thanku sir
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↑jvp with pedal oedema suggests rt heart dysfunction. + copd with sec infection. Judiciary diuretics use is beneficial to the patient.

Thanku sir
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Long standing asthma with cor pulmonale. Now presented with secondary infection. CXR shows cardiomegaly with ?Hyperinflation.

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Bronchial ashthma / copd with sec inf with ccf

Thanku sir
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COPD,corpulmonale with secondery infection

Thanku sir
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CORPulmonalae with secondary infection.

Thanku sir
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It looks like aspiration pneumonia

Thanku sir Can be one possible sir....! But as of now patient responding well and is shifted to wards....mainataining saturation without oxygen..... Meropenam Lasix And other supportive care..!! Responded wel
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