Concluded Case

DIABETES AND COVID 19

77yrs/M patient with a History of DM,HTN developed severe weakness and shortness of breath after a 5 days history of fever and chills.However, He subsequently develops respiratory collapse and was intubated.He appeared tachypneic, tachycardic, and was using accessory muscles.DIAGNOSIS AND SUGGEST TREATMENT AND MANAGEMENT PLAN? Chief Complaints SOB,Fever History DM/HTN Vitals BP - 140/80,PR -120,RR - 42,Spo2 - 82% on room air Investigations D Dimer - 1200,S.Ferritn - 800 , LDH -600 , CRP - 120.ABG enclosed,Trop I 675,CPK MB -26

LikeAnswersShare
Concluded answer

COVID-19 VIRAL PNEUMONIA FINDINGS IN FAVOUR OF COVID-19 disease 1.Clinical features - SOB , fever , tachycardia, tachypnea , Respiratory distress followed by sudden Respiratory collapse 2.Examination FINDINGS- PR - 120 , RR - 42 , SPO2- 82 % 3.INVESTIGATIONS - Significantly raised D - Dimer - 1200 , S.Ferritin- 800 , LDH- 600 , CRP - 120 , ABG - suggestive of Respiratory failure with respiratory acidosis 4.X- ray chest - Bilateral mid basal and left sided diffuse pulmonary parenchymal infiltrations - GGO 's and ARDS 5.Poor prognostic factors - Age -,77 years , DM , HTN 6.Cardiomegaly - may be part of LVH due to hypertension or COVID Myocarditis and pericarditis, TREATMENT 1.Mechanical ventilation 2.LMWH 3.Inj Dexamethasone 6 mg per day 4.Glycaemic control with insulin 5 Inj Remdesivir as per the dosage protocol 6.Parenteral antibiotics- 3rd generation cephalosporins 7.Supportive therapy

All Answers

Bil mid basal and left sided diffuse parenchymal infiltrating shadows seen. Aortic knuckle calcification seen. Cardiomegaly. Evaluate for covid pneumonia Echo CD. HRCT thorax. Electrolytes correction. NIV sos Invasive ventilation. Antibiotics, inj remdesivir if indicated. PCT and IL 6 level.

Valuable opinion
0

Type 2 res.failure or covid or kochs

COVID-19 VIRAL PNEUMONIA FINDINGS IN FAVOUR OF COVID-19 disease 1.Clinical features - SOB , fever , tachycardia, tachypnea , Respiratory distress followed by sudden Respiratory collapse 2.Examination FINDINGS- PR - 120 , RR - 42 , SPO2- 82 % 3.INVESTIGATIONS - Significantly raised D - Dimer - 1200 , S.Ferritin- 800 , LDH- 600 , CRP - 120 , ABG - suggestive of Respiratory failure with respiratory acidosis 4.X- ray chest - Bilateral mid basal and left sided diffuse pulmonary parenchymal infiltrations - GGO 's and ARDS 5.Poor prognostic factors - Age -,77 years , DM , HTN 6.Cardiomegaly - may be part of LVH due to hypertension or COVID Myocarditis and pericarditis, TREATMENT 1.Mechanical ventilation 2.LMWH 3.Inj Dexamethasone 6 mg per day 4.Glycaemic control with insulin 5 Inj Remdesivir as per the dosage protocol 6.Parenteral antibiotics- 3rd generation cephalosporins 7.Supportive therapy

Pulmonary oedema with GGOs bilateral Severe ARDS SPO2 is 82% severe hypoxia Tachycardia and tachyapnea ABG shows hyponatremia/hyperkalemia Respiratory alkalosis /metabolic acidosis All biomarkers are raised D-dimer s ferritin LDH are raised Crp is raised and positive Trop i is positive It is a c/o covid19 pneumonitis with ARDS Pt is in cytokine storm Hence need intubation and ventilatory support Intensive treatment Positive trop i suggest cardiomyopathy as CK-MB is positive Inj Remdesivir Inj dexamethasone Inj Ceftriaxozone Inj LMWH Inj azithromycin

Cardiomegaly Bilateral parenchymal infiltration Evaluate for covid Adv HRCT

Bilateral pneumonitis ? Covid and cardiomegaly

Thank you doctor
0

Cases that would interest you