GASTROENTEROLOGY(B)

 

A1.

·         The cause of pancreatitis in this case can be attributed to ALCOHOL.

                                                          In acute pancreatitis

                                                                 ↓

                          Premature activation of zymogen granules in pancreas

                                                                  ↓

                             Increased release of proteases into surrounding tissues

                                                                  ↓

             Pleural effusion due to seepage of fluid from abdominal cavity to thoracic cavity

                                                                     ↓

                                                                 DYSPNAE


A2.

                                                   In acute pancreatitis

                                                              ↓

                          there is destruction of pancreas(pancreatic cells)

                                                              ↓

                         pancreas is the only source for production of insulin

                                                            ↓

                insulin is the only hormone responsible for reducing blood sugars in blood

                                                            ↓

                                   therefore this leads to hyperglcemia

A3.

     Elevated LFT’s : may be due to alcohol causing liver damage.

   GGT- Gamma Glutamyl Transferase is most specific marker for alcoholic liver disease.

A4.

LINE OF TREATMENT

·        Intravenous fluids – 125 ml/hr

§  Given to treat dehydrated state as seen in acute pancreatitis.

·        INJ PAN : 40mg IV – OD

·        INJ ZOFER : 4 mg IV – SOS

·        INJ TRAMADOL: 1 amp in 100ml NS, IV, SOS

·        Tab Dolo : 650 mg SOS

·        GRBS charting- 6th hrly

·        BP charting- 8th hrly



Comments

Post a Comment

Popular posts from this blog

NEUROLOGY(D)

Image
  A1. Occurrence of seizure due to brain stroke: ·          Cells in the brain send electrical signals to one another ·          The electrical signals pass along your nerves to all parts of the body ·          A sudden abnormal burst of electrical activity in the brain can lead to the signals to the nerves being disrupted, causing a seizure ·          This electrical disturbance can happen because of stroke damage in the brain. ·          A seizure can affect vision, smell and taste, loss of consciousness and jerking movements. Mechanism of seizure activity: ·          You’re more likely to have a seizure if you had a haemorrhagic stroke (bleed on the brain). ·          Seizures can also be mor...
Read more

55yr old female with fever and headache

Image
Final exam Short case Name: M.Tejaswini Halltkt:1701006107 A 55yr old female came with chief complaints of: -fever since 4 days -headache since 4 days History of present illness Patient was apparently asymptomatic 4 days back then she developed fever which was insidious in onset, continous type relieved with medication and not associated with chills and rigors. Fever was associated with diffuse headache which was throbbing type present throughout the day and relieved with medication. There was 1 episode of vomiting which non projectile, non bilious, content was food. She also had neck stiffness. There's no history of photophobia, giddiness,seizures. Past history No similar complaints in past Not a known case of DM, HTN, TB, asthma, epilepsy Personal history Diet:mixed Appetite:normal Sleep:adequate Bowel and bladder: regular No addictions No known drug and food allergies Family history Not significant General examination Patient is conscious, coherent, coperative. Moderately built ...
Read more

INFECTIOUS DISEASE HEPATOLOGY(B)

 A1. Most likely cause is Amoebic liver abscess because of the following findings:             - Age of the patient             - Single abscess             - Right lobe involvement A2.  - right hypochondriac and epigastric pain , fever ➡ can be liver, biliary or right lower lobe pneumonia -Invesigations:          -CBP : Leucocytosis          -LFT : Elevated Alkaline phosphatase          -RFT           -Urine analysis           -USG : Single hyperechoic   oval shaped mass in right lobe                               ...
Read more