How to calculate dose of insulin
1 mg/kg
1 unit/kg
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50+ male patient, asthmatic, returning from a COVID-19-affected European country a few days earlier. Started to feel unwell before departure with fever and shortness of breath. No wheeze, hypoxia, tachypnea or tachycardia on assessment, only pyrexial with persistent dry cough. Arterial blood gas readings are all within range. Would you admit this patient? Would you swab this patient for the virus? Does the fact that he is asthmatic make a difference to your decision making? Would you prescribe antibiotics?
Dr. Zaka Yusto M7 Likes19 Answers - Login to View the image
50's male presented to the ER with shortness of breath and fevers for the last 2+ weeks. Fevers resolving in the last 3 days reportedly per patient. I became more Breathlessness prior to ER. No significant PMH. D-Dimer >20.
Dr. Shekhar Verma6 Likes23 Answers - Login to View the image
A 58 year old male, non-smoker, asthmatic patient was referred with 3 weeks history of breathlessness, wheezing, and dry cough. He had a history of acute severe asthma many years ago. However, he had not required ventilatory support during that period. Since then, he had self-medicating intermittently with oral salbutamol and theophylline only. On examination, the patient had dyspnoea at rest and tachycardia. Oxygen saturation was 90% on room air. Respiratory examination revealed bilateral polyphonic rhonchi; otherwise, he was normal. Arterial blood gas analysis revealed hypoxemia (PaO2: 54 mmHg) with respiratory alkalosis (pH: 7.43, PaCO2: 32.3 mmHg and Bicarbonate: 20 mEq/l). Let's discuss the case on today's World Asthma Day
Dr. Shekhar Verma1 Like20 Answers - Login to View the image
COVID-19?? 68 year old male with no significant past medical history or surgical history. Presented with shortness of breath, and chest pain. In the emergency department, the patient has a saturation of 79% on room air and is in Moderat respiratory distress. It requires 10 L of nasal oxygen high flow to obtain 93% oxygen saturation. The patient is also febrile to 101°F. Social history: non-smoker, non-drinker. Surgical history: no surgical history. What do you say about the case?
Dr. Shekhar Verma5 Likes35 Answers - Login to View the image
44-year-old male, stigmata of HIV, presented with shortness and respiratory distress. Patient was intimated and sedated. The patient is a known MDR-TB patient, on further investigation found to have completed treatment in 2015. Other history was not obtained. On arrival patient x/ray reviewed (attached - Image 1) and bilateral infiltrates noted as well as ? right lung mass. The patient sent for urgent non-contrast CTB (NAD) and chest. CT findings: ‘Basal infiltrates bilaterally, no cavities, faint effusions with no gross adenopathy. Active TB is very unlikely. Cardiomegaly with PAH. Paraseptal emphysema - mild degree only. Right pericardiac mass (mediastinal).” Patient management is ongoing. What are your valuable suggestions?
Dr. Akhil Sharma6 Likes32 Answers
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