General medicine short case

 



30/07/22

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A 13 year old school going boy presented to opd with cheif complaints of 

- high grade fever since 4 days

- vomitings since 4 days

- giddiness since 4 days

- loose stools since 1 day

HISTORY OF PRESENT ILLNESS - 

Patient was apparently asymptomatic 4 days back then he developed fever associated with chills.

Complaints of vomiting since 4 days- 2-3 episodes/day with food particles as content

Loose stools- 5 episodes in the past one day

No history of burning micturion, rashes, bleeding gums, hematuria


VITALS

Temp- 98.8 F 

PR- 90 bpm

BP- 100/60 mmHg 

RR- 18 cpm

Spo2- 98% at RA

GRBS- 118mg%

GENERAL EXAMINATION

Patient is conscious, coherent and cooperative well oriented to time and place and have no signs of - 

Pallor  

Icterus 

Cyanosis 

Clubbing 

Lymphadenopathy or Edema.






SYSTEMIC EXAMINATION

CVS: S1 S2 heard, no murmurs/thrill sp

Position of trachea central

Palpation of Abdomen: Soft, non tender. Liver and Spleen not palpable. 

Bowel sounds heard


INVESTIGATIONS

Outside Reports:-

Platelets- 102000 lakhs/cu.mm

Hb- 15.6 mg/dl

TLC- 2,300

PLT- 45,000

BGT- AB POSITIVE

BLOOD MALARIAL PARASITE- NEGATIVE

RBS- 110 mg/dl

DENGUE NS1 +


Serum Urea- 13

Serum Creatinine- 0.6

Na- 135

K- 3.0

Cl- 96


Total Bilirubin- 0.40

Direct Bilirubin- 0.18

Aspartate aminoTransferase- 10

Alanine aminotransferase- 9

Alkaline phosphatase- 110


USG ABDOMEN 


ECG


CHEST X-RAY 


PROVISIONAL DIAGNOSIS

NS 1 + DENGUE


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