Generalized muscle ache
Chief Complaint A 45 y/o female came for fever, headache & muscle ache, and swelling of both arms. History She had urinary track infection 10 days back and taken antibiotic course for that. Vitals Vitals are wnl Investigations BP: 110/70 mmhg, Resp rate: 17 bpm, HR: 75 bpm, Temp: 101 degree F. O2 saturation-99% on room air. Examination Cardiac and pulmonary exam normal. Abdomen was tender to palpation. Arms and legs muscles are also tender to palpation. Investigations WBC: 14500/mm3, Hb: 11.7 g/dL, Platelets: 289,000/mm3 Total bilirubin: 1.8 mg/dL, direct bilirubin: 1.4 mg/dL, AST: 59 u/l, ALT: 127 u/l, Alkaline Phosphatase: 337 u/l Urine analysis shows presence of wbcs. Treatment Please give your advice.
Hepatitis developing after initial treatment given for UTI which still shows pus cells and hemogram shows leucocytosis LFTS are deranged So in my opinion it is drug induced hepatitis with jaundice or bacterial hepatitis Rx iv fluids Inj dexamethasone Inj Ceftriaxozone Inj pantaprazole Inj ondestron Inj hepamerz Send urine for c&s Multivitamins Once settled down shift on oral treatment
Do urine culture sensitivity. Abdominal ultrasound to see for any hydro/ pyelonephrosis. Also to rule out appendicitis and other causes of acute abdomen Start syp cital tds. Novefos 1 sachet in 1 glass of water HS once after collecting urine for c/s
Jaundice with u T L X RAY CHEST and USG Abdo. Urine complete and sensitivity RT -PCR 2unxer present circumstances covid 19 must be ruled out and protocols must be followed. Needs further investigation and evaluation to conclude and line of treatment.
Recurrent urinary tract infection Please do USG abdomen and KUB to look for cause of recurrent urinary tract infection Look for stone disease, hydronephrosis and look for post void residue as cause of recurrent urinary tract infection Do urine routine and culture Antibiotic according to culture and sensitivity
Here are possibilities Recurrent UTI with jaundice Sub clinical hepatitis Acute cholecystits Pancreatitis Appendicitis Rull out covid 19 Adv: urine c/s, USG abdomen, s, amylase,
Viral hepatitis. Urine to be re investigated Micro & CS. It can be relapse of UTI. USG And & Pelvic. Execute fluid intake. Antibiotic as par sensitivity recommendation. Alkalizer.
?UTI SECONDARY TO VIRAL HEPATITIS USG ABDOMEN URINE FOR C/S CBC,ESR, ANTIBODY ANTIGEN FOR MP,WIDAL,IGG IGM NS1 DENGUE, AND RTPCR FOR COVID-19 TO CONCLUDE
Urine culture and sensitivity Urine routine and microscopic Ultrasound KUB and abdomen Mostly uti or renal calculus
Looks like uTI Do urine cult n sensitive Also. RT.PCR
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C/o A 56-year-old woman complaining of abdominal pain. Twenty-four hours previously she developed a continuous pain in the upper abdomen which has become progressively more severe. The pain radiates into the back. She feels nauseated and alternately hot and cold. H/o duodenal ulcer which was successfully treated with Helicobacter eradication therapy 5 years earlier. on Examination... The patient looks unwell and dehydrated. She weighs 115 kg. She is febrile, 38.5°C, pulse is 108/min and blood pressure 124/76 mmHg. She is tender in the right upper quadrant and epigastrium, with guarding and rebound tenderness. Bowel sounds are sparse. What is the most likely diagnosis?
Nitin Goje0 Like4 Answers - Login to View the image
10 year FEMALE PATIENT PRESENT WITH pain ABDOMEN , vomiting , FEVER, CONVULSION SINCE 3- 4 days . USG ABDOMEN AND STRAIGHT XRAY ABDOMEN ERECT POSTURE REPORT ATTACHED. BLOOD REPORT SUGGESTIVE OF NEUTROPHILIC LEUCOCYTOSIS. BLOOD SUGAR, SGPT, SERUM CREATININE, POTASSIUM, CALCIUM, CHLORIDE, MALARIA TEST, QBC IS WITHIN NORMAL LIMIT. SODIUMIS 128, SRUM BILIRUBIN IS 2.46 TOTAL , DIRECT 1.60, INDIRECT 0.86, SERUM AMYLASE IS 264, SERUM LIPASE IS 123, CRP IS 56. PLATELET COUNT IS NORMAL. PROVISIONAL DIAGNOSIS AND TREATMENT. USG REPORT IS BILATERAL MINIMAL ECHOGENIC KIDNEYS, CONTRACTED AND THICK EDEMATOUS GALL BLADDER, MILD ASCITES AND MINIMAL FLUID IN BILATERAL PLEURAL CAVITY, MILDLY DILATED MAIN PANCREATIC DUCT AND MILDLY DILATED CBD AT PORTA, FEW BORDERLINE DILATED GUT LOOPS IN ABDOMEN.
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A 35 Y/F CAME TO ED WITH SEVERE PAIN IN ABDOMEN (RT. HYPOCHONDRIAC REGION ),,1-2 BOUTS OF VOMOTTING AND UNESAYNESS, ,,NO HTN /dm/BA /IHD, ,NO H/O --ANY MAJOR ILLNESS, ,O/E --T-;:99'F, ,B. P --110/70 MM OF HG, ,HR -106 /MIN, ,SPO2 --98 PERCENT AT ROOM AIR, ,,,P/A --SOFT TO PALPATE, ,FINGER TENDER NESS AT RT. HYPOCHONDRIAC REGION, ,NO GUARDING, ,NO RIGIDITY, ,,UO --NORMAL, ,,BELOW R THE VALUES AND IMPRESSION OF BLOOD INVESTIGATION AND USG (A &P ),,SO DEAR FRENDS AND GENTLEMEN PLZZ HELP IN DX AND MX, ,,,REGARDS; ;DR RAJ PANDEY MISHRA
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45 yr male report attached kindly suggest management plz complaint of pain abdomen
Dr. Mohd Shamim0 Like13 Answers - Login to View the image
F 30 multiparty attended ER with c/o severe pain abdomen on Rt hypochondrium radiating towards mid abdomen mainly upper epigastrium & to the back with shivering (due to cold) with 2 episodes of vomiting.No HTN,No DM. Advice USG abdomen,ECG,CBC, Amylase Lypase,LFT, Treatment NPM,IV fluids 6 hourly,Inj Cefrrixone 1gm BD Inj Amikacin 500mg BD,Inj Pantaprazole 40 mg BD,Inj Tramadol 100mg TDS,Inj Diazepam,Inj Metronidazole 500mg TDS,Inj Onsansetron stat & SOS,Inj Drotavarin 80 mg stat.Interpret ECG,PD & Line of management.Sorry for tracing quality.
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