A Complicated case of COPD by Dr. Mahananda

Expert Insights brings another case by our Expert Dr. Mahananda Share your experience on this complicated case of COPD with chronic renal failure Follow us for more such updates!

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One of the rare cases of COPD with CRF with Myxiedema coma- very elaborately presented by Dr Mahananda in Experts Insights case. Patient was managed as per the emergency protocols .It was a really informative case for all of us with key learnings Myxedema coma is typically a sequela of chronic severe thyroid hormone deficiency and is characterized by deterioration of mental status, hypothermia, hypotension, hyponatremia, and hypoventilation. It is one of the most urgent and lethal endocrine conditions. Criteria and scoring system for the diagnosis of myxedema coma, based on specific clinical features and laboratory data, have been proposed, but no consensus has been reached. However, early recognition and commencement of treatment based on clinical suspicion is recommended, rather than waiting for laboratory results .A history of thyroidectomy, radioiodine therapy, or sometimes just hypothyroidism may be important clues of myxedema coma. Few studies to date, however, have assessed the association between myxedema coma and renal failure. Although decompensated hypothyroidism is a rare endocrine emergency, but differentiation from other, similar conditions are important for critically ill patients presenting with systemic illness

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NICE ILLUSTRATION CHRONIC OBSTRUCTIVE PULMONARY DESEASE ISCA KIND OF LUNGBDESEASE WHICH IS SECONDRY TO CHRONIC BRONCHITIS BRONCHIECTASIS B ASTHAMA AT PRESENT DUEVTO COVIDB19 PANDEMIC COPD WILL BECOME MORE WORSE SO WE HAVEVTO BE VERY VIGILANT

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Well managed case suffering from COPD and other co morbidities like CRF , coronary disease and thyroid distinction etc. Very complicated case investigated and evaluated with precision. Line of management was very difficult keeping the side effects of various medicine prescribed for ailments pt suffering from. Congratulations and appreciation for sharing this case.

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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Complicated Case of COPD with chronic renal failure with pericardial effusion and Myxedema properly investigated and tackled congratulations Dr Mahananda

Nicely illustrated case of COPD wth CRF nd other co morbidities. In chronic renal failure makes difficult u choice nd management Well maneged case. Congratulations nd thanks for shairing ma'm !

Well managed case as per the protocol. Congratulations. only two questions.. First-Why this patient was not treated with LMWH even after history of CAD/Post PTCA / DM and when she is intubated and on MV under sedation ? Second - why she was taking spironolactone? what was the indication of prescribing pottasium sparing diuretic to a patient of CRF/CKD.?

The link between COPD and kidney disease has been investigated previously. Studies have reported that COPD is an independent predictor of reduced kidney function and that it is the severity of emphysema, rather than airflow limitation, that may be most closely associated with reduced glomerular filtration rate.Respiratory complications of chronic renal failure include pulmonary edema, fibrinous pleuritis, pulmonary calcification, and a predisposition to tuberculosis. Urinothorax is a rare entity associated with obstructive uropathy.Goodpasture syndrome is a rare but serious autoimmune disease that attacks the lungs and kidneys. The disease occurs when the body's immune system mistakenly produces antibodies against collagen in the lungs and kidneys. Collagen is a protein that helps form connective tissue.The COPD groups had significantly worse renal function and significantly decreased glomerular filtration rates compared with the placebo group. The COPD groups also had a greater percentage of participants with concealed chronic renal failure compared with the placebo group.The 2nd COPD group had a significantly higher percentage of concealed chronic renal failure compared with the 1st COPD group and the control group. In all 3 groups, the percentages of participants with concealed chronic renal failure were greater than those with overt chronic renal failure. Estimated glomerular filtration rate was significantly correlated with all clinical and spirometry data. Serum creatinine levels were significantly correlated with COPD assessment test, exacerbations/hospitalizations, percent-of-predicated FVC, percent-of-predicted FEV1/FVC, percent-of-predicted maximum mid-expiratory flow, and percent-of-predicted peak expiratory flow

Now a days more and more people suffered from COPD. At this circumstances this nice presentation is very helpful.

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Well taken ... good line of treatment...

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