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Pt admitted with the above complaints on examination gc v poor prognosis and explained. Chief Complaints Pain abd with nausea and vomiting for 10 days Mild fever with yello discolouration of eyes and face 6 days Low urine output for 3 days Altered sensorium since last night History Known Alcoholic smoker Vitals Bp 140/80 hr 93/min spo2 94% afebrile Cns dull Cvs trachycardia E2 v1 m2 Investigations Hb 12 Tlc 38000 Bilirubin 35 Creat 9.0 Urea 260 Lipase 650 Diagnosis Deep jaundice renal failure hepatic encephalopathy Management Ppi Iv antibiotics inj meropenam inj augmentin Hepato tonic Iv fluid Adv for haemodialysis

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Multiple organ failure Septicaemia with hepatic encephalopathy and CLD c CKD Look for pancreatitis serum amylase lipase Usg whole abdomen and Sos cect whole abdomen Also check ammonia level.. Npo RT insert Urgent dialysis Add syp Lactolose + diuretic.. + inj hepamerz + Rifaximin tab + RCST Maintain vital input output charting is important in this case Prognosis seems to be poor...

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Well done.

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