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53yrs/M with History of Fever on n off ,productive cough and worsening SOB since 5days duration.He denied any H/o Travel,Sore throat,nasal congestion or headache.He has a medical H/o HTN,T2DM with CKD is on hemodialysis and had a Partial nephrectomy for benign kidney tumor 3yrs back. On admission patient was Conscious, afebrile,Not maintaining o2 saturation (Spo2 -85% with 8litre/min oxygen support),BP - 150/90,RR - 28/mt. Labs - Hb -6.7,TLC -7000,CRP - 148,S.Ferritin - 600,D-dimer -3000,Urea -42,Creat -2.4 Output normal.ABG - Ph -7.2,Pco2 -58,Po2 -32,Na - 132,K -5.1.Chest - Inspiratory crackles more prominent in the right side.INTERPRET CXR AND HRCT CHEST AND SUGGEST TREATMENT AND MANAGEMENT PLAN WOULD APPRECIATE OPINION?? *Chief Complaints* Fever,SOB,Cough *History* HTN,CKD,T2DM *Vitals* P - 150/90,RR - 28/mt,Spo2 -85% *Physical Examination* Chest - Coarse Inspiratory crackles more prominent on the right side *Investigations* Hb -6.7,TLC -7000,CRP - 148,S.Ferritin - 600,D-dimer -3000,Urea -42,Creat -2.4 Output normal.ABG - Ph -7.2,Pco2 -58,Po2 -32,Na - 132,K -5.1.
Dr. Prashant Vedwan5 Likes13 Answers - Login to View the image
50yrs old male patient brought emergency department with complaints of breathing difficulties and a flu like presentation for 2 days.Two hours after admission patient condition studdenly deteriorated(Spo2 dropped from 92 to 75%) and respiratory rate increased to 45/min).Intubated and put on invasive ventilation.Poor prognosis explained *Vitals* Bp - on inotropes support,HR -130,Spo2 -78%,RR -45 *Physical Examination* Chest - B/l Full of crepts,Pupils - B/l Small size non reactive,GCS - 3/15 *Investigations* D dimer - 10000,Hb -10,TLC -9000(N -95,L 12),Na -129,K - 2.3,Ph - 7.2,Pco2 -45,po2 -22,Hco3 -13,LFT n KFT normal RT PCR FOR SARS COV 2 NEGATIVE
Dr. Prashant Vedwan2 Likes10 Answers - Login to View the image
33 y/o female with chest pain, difficulty on breathing, and heart palpitation. diagnosis???
Dr. Anirudh Mishra3 Likes25 Answers - Login to View the image
A 60 year old male patient k/c/o ca esophagus on chemotherapy. yesterday he went for his normal chemo was found toh have hyponatremia was give sodium correction after after 15 mins he had tachypnea with low spo2 was given o2 and had fever blood culture was positive for dengue today with ascites with low urine output was shifted to icu usg showed the below findings pls provide any proable diagnosis
Dr. Ayaz Shaikh3 Likes15 Answers - Login to View the image
30yr primi lscs done in govt hospital ,after 5 hrs no urine output ,ARF ,all needfull done ,but useless no response Bp120/50,p100,rr16/min,oxygen saturation 89-90,forcefull breating Pls advice needfull
Dr. Asha Trivedi1 Like23 Answers