SIDE EFFECT OF THIAZIDE
This case taken from Book .. A 74 year old female patient .k/c/o Hypertension for the past 2 years C/O Altered behavior and irrelevant talking She is on HCTZ 12.5 O/E CNS - no focal neurological deficit CVS S1 S2 heard Chest clear CT head - normal S Na 118 S K 4.2 What is diagnosis and how would manage the patient ??
Hyponatremia , ? Due to prolonged use of hydrochloric thiazide . Inter current illness which reduce solid intake, increase fluid intake , hypothyroidism, infections can precipitate hypo natremia. Admission ,fluid restriction, increase salt intake to 10 gms/ day, soda mint tablets .IV hypertonic saline, tolvaptin
Might be case of Hyponaturima as information given Correct sodium level See for ecg and normal blood test See for sr calcium and sr vit d3 See ammonia also to rule out metabolic cause See urine routine also
Hyponatremia presenting with altered behavioural disorder Just correct the imbalance Find the cause of hyponatremia R/o hypertensive renal damage
Symptoms are due to Hypoprotinemea , Serum Sodium level of pt is to be Maintained normal
It happens due to Low sodium Maintain it .
Hyponaturima Current sodium levels and symptomatic treat and lipid profile and Ecg routine urine analysis rft d3 and Vit b12 need
Cases that would interest you
- Login to View the image
A 20 y/o female admitted for suicidal ideation. Denies ingestion of anything. History of Mobitz II. HR 45-60 dropping to the 30s when sleeping. BPs on the lower end of normal. Patient’s only complaint is dizzy spells a few times a week without syncope and occasional fatigue. All other vitals within normal limits, labs and physical assessment unremarkable. Diagnosis based on ECG was complete heart block. Dual chamber pacemaker placement pending. Any other thoughts on this ECG reading?
Dr. Amirul Venkat4 Likes21 Answers - Login to View the image
A female aged 45 years who is a k/c/o Hypothyroidism on treatment with Morbid obesity p/w complaints of Burning in Chest since last night....She also complains of Pain in Right arm....comment on her ECG and discuss the findings
Dr. Hardik Ahuja1 Like17 Answers - Login to View the image
pl interpretate and suggest treatment for enclosed report of thyroid profile of a 45 yrs f .
Dr. Ashok Leel2 Likes15 Answers - Login to View the image
26 yrs married f presenting severe anemia,sob on exertion, swelling of both upper and lower extremities, puffiness of face, white conjunctiva,pale face, irregular menses with scanty flow h/o migraine no h/o dm,htn,piles bp 90/50 pr 100/mt spo2 97 one unit B.T. done yesterday
Dr. Satish Kumar1 Like21 Answers - Login to View the image
fracture C3&C5 Vertebral Body of 45yrs female ,Hypothyroidism & on treatment ,Diabetic on Oral Hypoglycaemics. H/O fall in bathroom 5mnths back .No Xray done previously. C/O pain in arms & neck,shoulders.No MRI done.Parasthesias in fingers& thumbs.No motor loss. Plz guide further course of management.Thnx
Dr. Rajinder Rai2 Likes16 Answers
2 Likes