The document describes a case study of a 45-year-old female patient admitted to the hospital with complaints of pain in the right upper abdomen, discomfort in the upper abdomen for 1 month, and nausea. On examination, she was found to have tenderness in the right hypochondrium. Ultrasound revealed cholelithiasis. The provisional diagnosis was cholelithiasis. The patient was treated conservatively and the planned treatment is laparoscopic cholecystectomy.
A 49-year-old male presented with a swelling in his right inguinal region that had developed over 4 years. He reported pain in the area for the past 15 days. On examination, a 2.5x2.5cm globular, non-reducible swelling was found in the right femoral region. Ultrasound revealed an irreducible right femoral hernia that was not obstructed. The patient underwent open surgery using the Lockwood approach under spinal anesthesia, where a right femoral hernia containing approximately 20ml of peritoneal fluid was found and repaired.
- Cellulitis is a bacterial skin infection that causes inflammation of the inner layers of skin and subcutaneous tissue. It commonly affects the legs and develops when bacteria enter through breaks in the skin.
- A 60-year old male patient was admitted with swelling, pain and tenderness in his left foot and was diagnosed with cellulitis based on his symptoms, medical history of diabetes, and CT scan results.
- He was started on a treatment regimen including antibiotics like metronidazole, tramadol for pain, and diclofenac gel to address the infection, symptoms, and prevent complications.
The document summarizes a case of a 16 month old female patient named Naseeba who presented with pallor and difficulty breathing for the past month and 5 days respectively. She was diagnosed with thalassemia major based on her history of severe anemia requiring regular blood transfusions since 8 months of age. Her examination revealed signs of severe anemia, failure to thrive, and secondary malnutrition. The discussion section provided an overview of thalassemia including pathogenesis, classification, management with regular blood transfusions and chelation therapy, as well as complications. It emphasized the importance of lifelong management, counseling, and screening to improve quality of life for patients with thalassemia major.
The document describes a case of a 19-year-old male student who sustained a tibia fracture 4 months ago during a rugby match and was admitted for surgery to treat a non-union of the fracture. Examination found deformity, restricted movement, and mobility at the fracture site. The patient will undergo surgery involving fibular osteotomy, removal of necrotic bone, reamed intramedullary nailing, and compression plating to treat the non-union.
This document summarizes information about a 2-year-old male patient named Master Sahitya who was admitted to the hospital for pneumonia. It includes his medical history, physical exam findings, lab results, treatment including antibiotics, and nursing care plan. The patient had a fever, cough and breathing difficulties and was diagnosed with pneumonia likely caused by a previous viral infection. He received antibiotics and other treatments during his hospital stay.
A 16-year-old boy was admitted to the hospital after a traffic accident where he fell from a motorcycle. He reported pain in his left thigh. Examination found deformity, hematoma, and swelling of the left femur region with tenderness. X-rays showed a closed fracture of the middle third of the left femur. He was diagnosed and treated with open reduction internal fixation surgery.
chronic kidney disease case presentationKamal Sharma
This document presents a case study of a 59-year-old female patient with chronic kidney disease (CKD) who was treated with Ayurvedic therapies including udwarthana, takradhara, and triphaladi lekhana basti. The patient had a history of hypertension, CKD, and urinary symptoms like burning sensation and frequency. Laboratory tests showed elevated creatinine and BUN levels. She was treated with various internal Ayurvedic medications and external therapies over a period of time, which resulted in reductions in her symptoms, fatigue, creatinine and BUN levels. The case study evaluates the effectiveness of the Ayurvedic treatment approach for managing this patient's CKD.
1. A 35-year-old male was admitted to the hospital with abdominal pain and nausea and was diagnosed with acute pancreatitis based on elevated serum amylase and lipase levels and abdominal ultrasound findings.
2. He was treated with IV fluids, pantoprazole, ondansetron, tramadol, thiamine injections, and later ceftriaxone injections. His condition was monitored over three days and showed improvement.
3. Acute pancreatitis can be caused by gallstones, heavy alcohol use, certain medications, and other factors. It leads to inflammation of the pancreas and pain in the upper abdomen. Treatment focuses on pain relief, rehydration, and addressing the
A 49-year-old male presented with a swelling in his right inguinal region that had developed over 4 years. He reported pain in the area for the past 15 days. On examination, a 2.5x2.5cm globular, non-reducible swelling was found in the right femoral region. Ultrasound revealed an irreducible right femoral hernia that was not obstructed. The patient underwent open surgery using the Lockwood approach under spinal anesthesia, where a right femoral hernia containing approximately 20ml of peritoneal fluid was found and repaired.
- Cellulitis is a bacterial skin infection that causes inflammation of the inner layers of skin and subcutaneous tissue. It commonly affects the legs and develops when bacteria enter through breaks in the skin.
- A 60-year old male patient was admitted with swelling, pain and tenderness in his left foot and was diagnosed with cellulitis based on his symptoms, medical history of diabetes, and CT scan results.
- He was started on a treatment regimen including antibiotics like metronidazole, tramadol for pain, and diclofenac gel to address the infection, symptoms, and prevent complications.
The document summarizes a case of a 16 month old female patient named Naseeba who presented with pallor and difficulty breathing for the past month and 5 days respectively. She was diagnosed with thalassemia major based on her history of severe anemia requiring regular blood transfusions since 8 months of age. Her examination revealed signs of severe anemia, failure to thrive, and secondary malnutrition. The discussion section provided an overview of thalassemia including pathogenesis, classification, management with regular blood transfusions and chelation therapy, as well as complications. It emphasized the importance of lifelong management, counseling, and screening to improve quality of life for patients with thalassemia major.
The document describes a case of a 19-year-old male student who sustained a tibia fracture 4 months ago during a rugby match and was admitted for surgery to treat a non-union of the fracture. Examination found deformity, restricted movement, and mobility at the fracture site. The patient will undergo surgery involving fibular osteotomy, removal of necrotic bone, reamed intramedullary nailing, and compression plating to treat the non-union.
This document summarizes information about a 2-year-old male patient named Master Sahitya who was admitted to the hospital for pneumonia. It includes his medical history, physical exam findings, lab results, treatment including antibiotics, and nursing care plan. The patient had a fever, cough and breathing difficulties and was diagnosed with pneumonia likely caused by a previous viral infection. He received antibiotics and other treatments during his hospital stay.
A 16-year-old boy was admitted to the hospital after a traffic accident where he fell from a motorcycle. He reported pain in his left thigh. Examination found deformity, hematoma, and swelling of the left femur region with tenderness. X-rays showed a closed fracture of the middle third of the left femur. He was diagnosed and treated with open reduction internal fixation surgery.
chronic kidney disease case presentationKamal Sharma
This document presents a case study of a 59-year-old female patient with chronic kidney disease (CKD) who was treated with Ayurvedic therapies including udwarthana, takradhara, and triphaladi lekhana basti. The patient had a history of hypertension, CKD, and urinary symptoms like burning sensation and frequency. Laboratory tests showed elevated creatinine and BUN levels. She was treated with various internal Ayurvedic medications and external therapies over a period of time, which resulted in reductions in her symptoms, fatigue, creatinine and BUN levels. The case study evaluates the effectiveness of the Ayurvedic treatment approach for managing this patient's CKD.
1. A 35-year-old male was admitted to the hospital with abdominal pain and nausea and was diagnosed with acute pancreatitis based on elevated serum amylase and lipase levels and abdominal ultrasound findings.
2. He was treated with IV fluids, pantoprazole, ondansetron, tramadol, thiamine injections, and later ceftriaxone injections. His condition was monitored over three days and showed improvement.
3. Acute pancreatitis can be caused by gallstones, heavy alcohol use, certain medications, and other factors. It leads to inflammation of the pancreas and pain in the upper abdomen. Treatment focuses on pain relief, rehydration, and addressing the
- The patient, a 35-year-old male, presented with abdominal pain and vomiting for 2 days. On examination, he had tenderness in the right lower abdomen.
- Laboratory tests and imaging confirmed a diagnosis of appendicitis. He received IV antibiotics and underwent a laparoscopic appendectomy.
- The clinical pharmacist reviewed the patient's medications and provided recommendations to avoid potential drug interactions and maximize treatment of appendicitis.
This document describes the case of a 3 year old female child presented with huge hepatomegaly, hypoglycemia, and metabolic acidosis. On examination, she had doll-like face and protuberant abdomen with huge hepatomegaly but no splenomegaly. Laboratory tests showed hypoglycemia but normal renal and liver function tests. She had several admissions for severe metabolic acidosis and hypoglycemia. A liver biopsy was performed. The differential diagnoses being considered included glycogen storage disorder (GSD) or fatty oxidation disorder given the presentation of hypoglycemia, hepatomegaly, and metabolic acidosis. Further investigation was needed to make a diagnosis and determine appropriate treatment.
This case presentation describes a 9-month-old male child admitted to the pediatric unit with febrile seizures. He presented with a 1-week history of fever, cough and cold, and experienced 3 seizure episodes lasting 10 minutes each. His condition was diagnosed as complex (atypical) febrile seizures. His treatment included antibiotics, anticonvulsants, and supportive care. Febrile seizures typically occur in children 6 months to 5 years old during fevers caused by infections and resolve on their own without long-term issues.
Shoulder dystocia occurs when the shoulders become lodged inside the mother's pelvis during childbirth, requiring additional obstetric maneuvers to deliver the baby after gentle traction has failed to dislodge the shoulders. Risk factors include maternal diabetes, obesity, and previous shoulder dystocia as well as fetal macrosomia and postmaturity. The HELPER mnemonic outlines the standard management steps to reduce the shoulder diameter and gain space in the maternal pelvis, including calling for help, applying suprapubic pressure, and internal rotation of the shoulders.
This is a case study done by me as a part of my in-service education progamme in my institution...hope this may help all nurses who wants to do a case study.
This document provides a case history for a 2.5 year old female child named Shreya who presented with an enlarged head, vision loss, and seizures. Her developmental history revealed global developmental delay. On examination, she had macrocephaly, hypertonia, and upgoing plantars. Investigations showed communicating hydrocephalus. She has been diagnosed with hydrocephalus, for which the treatment is either medical management to temporarily relieve symptoms or surgical intervention like ventriculo-peritoneal shunt placement.
Nanay Ganda, an 84-year-old female, was admitted to the hospital with complaints of inability to defecate for 4 days and intermittent abdominal pain over the past year. Imaging showed signs of partial intestinal obstruction. She underwent exploratory surgery where a tumor was discovered and removed at the descending colon. Biopsy results of the tumor were pending. Intestinal obstruction can be caused by adhesions, hernias, tumors and other issues. It requires prompt diagnosis and treatment, like surgery, to avoid increased mortality if left untreated.
The document discusses a case study of a 24-year-old female patient named Kalpana Pandit who was admitted to the hospital for cholelithiasis (gallstones). It provides details of her medical history, symptoms, physical examination findings, diagnosis, and treatment plan. The causes and risk factors for cholelithiasis are also briefly explained.
Mrs. Omi Devi, a 67-year-old female, presented with abdominal pain for 12 days and was diagnosed with cholelithiasis after an ultrasound revealed gallstones. She has a history of diabetes and hernia surgery. On physical examination, she had pain in her abdomen on palpation at the site of her recent laparoscopic cholecystectomy. Her lab tests showed elevated bilirubin levels. She is being treated medically with antibiotics and pain medications and was advised dietary and lifestyle modifications to manage her condition.
Pregnancy Induced Hypertension - Pre eclampsiaomar143
This document provides information about a 33-year-old pregnant woman admitted to the hospital with mild preeclampsia at 36 weeks of gestation. It includes her medical history, symptoms, physical exam findings, lab results, diagnosis, and notes on preeclampsia and its management. The key details are that she presented with swelling in her lower limbs and a history of amenorrhea for 8 months, and was found to have elevated blood pressure and mild preeclampsia at 36 weeks of pregnancy.
A 33-year-old male presented with sudden onset weakness of the limbs for 7 hours. He has a history of similar episodes in the summer after excessive work. On examination, he had weakness of proximal and distal muscles of all limbs. Laboratory tests found hypokalemia, metabolic alkalosis, hypomagnesium, and low urinary calcium levels. He was diagnosed with Gitelman's syndrome based on the clinical and laboratory findings. Gitelman's syndrome is an autosomal recessive disorder characterized by hypokalemia, metabolic alkalosis, hypomagnesium, hypocalciuria, and normal blood pressure.
The patient is a 57-year-old female who presented with a rapidly enlarging swelling in her neck accompanied by pain. She has had a history of a multinodular goiter for over 30 years. On examination, her thyroid gland was enlarged bilaterally with the right lobe being larger than the left. She has no other associated symptoms. Her past medical history and family history are unremarkable. She is scheduled for surgery to address the enlarging goiter.
This document provides an overview of inguinal hernias. It defines a hernia as the protrusion of an organ through a weakness in the muscle wall. It then discusses the epidemiology, types, anatomy, etiology, pathogenesis, signs and symptoms, diagnosis, treatment and complications of inguinal hernias. The treatment options covered are herniotomy, herniorrhaphy, and laparoscopic repair techniques like the Lichtenstein method. The prognosis is typically good, though there is a small risk of recurrence.
Acute glomerulonephritis is an acute inflammation of the renal glomeruli characterized by sudden onset of oliguria, hematuria, hypertension and edema. It is commonly caused by a streptococcal infection and results in the deposition of immune complexes in the glomeruli. On pathology, glomeruli appear enlarged and infiltrated by polymorphs with epithelial crescents. Immunofluorescence shows "lumpy-bumpy" deposits of immunoglobulin and complement. Management involves controlling hypertension and edema with diuretics, treating any underlying infection, and managing complications such as acute renal failure. The prognosis is generally good with complete recovery in most cases.
UG CASE PRESENTATION ON INGUINAL HERNIAAyesha Huma
I have added viva notes after this proforma for quick revision of important stuff asked in exam.
LINK FOR EXAMINATION VIDOES :
1. https://youtu.be/uO-w_9w5okI
2. https://youtu.be/Vc_ZH_-Oad4
It usually takes about 6 weeks to recover from your c-section but this will depend on your individual situation. If you had any problems during or after your c-section, or if you’re looking after other children at home, you may feel you need more time to recover.
This document contains information about a 54-year-old female patient named Jubedabivi Bharubhai Kakar who was admitted to the hospital for a total mastectomy due to breast carcinoma stage 3. It includes her medical history, physical examination findings, lab results, diagnosis, treatment plan including chemotherapy and surgery, and nursing care plan. The patient presented with complaints of fever, pain and lump in the left breast, and was diagnosed with breast carcinoma based on biopsy, ultrasound, MRI and mammography results. She underwent a total mastectomy and is being treated with chemotherapy.
A 34-year-old male presented with a 1-year history of a painless, progressively enlarging mass above the umbilicus. Examination revealed a 2x2 cm reducible swelling above the umbilicus that increased in size with coughing. Imaging showed a paraumbilical hernia. The patient underwent hernioplasty using an anatomical repair with mesh placement. Post-operatively, the patient recovered well without complications.
1. This patient presented with periodic paralysis caused by both hyperthyroidism (thyrotoxic periodic paralysis) and renal tubular acidosis. The hyperthyroidism prevented symptoms from manifesting until after delivery when potassium levels dropped further.
2. The initial nerve conduction study showed demyelination likely due to the previous episode being treated as a demyelinating disease.
3. Going forward, the patient will need long-term management of their hyperthyroidism, renal tubular acidosis, and further evaluation for Sjogren's syndrome. Potassium and bicarbonate supplementation as well as thyroid medication will be required.
Obs jaundice for whipple procedure ppt.pptxdeepti sharma
A 52-year-old man presented with progressive jaundice, dark urine, clay-colored stools, and weight loss over 4 months. Examination found icterus and a firm, non-tender lump in the right upper abdomen. Imaging showed biliary duct dilation likely due to a stricture. The working diagnosis was obstructive jaundice possibly due to a malignancy, for which Whipple's surgery was planned. Anesthetic considerations included the patient's poor nutrition and smoking history, as well as concerns related to the long surgery, blood loss, and effects of anesthesia on liver function and blood flow.
- Mrs. Shahnaz, a 40-year-old housewife, presented with 4 days of right upper abdominal pain and 2 days of vomiting.
- On examination, she had tenderness in the right hypochondriac region and Murphy's sign was positive.
- Ultrasound showed cholelithiasis with cholecystitis.
- She was diagnosed with acute cholecystitis and treated conservatively with antibiotics, analgesics, antispasmodics and anti-ulcer medications.
- The patient, a 35-year-old male, presented with abdominal pain and vomiting for 2 days. On examination, he had tenderness in the right lower abdomen.
- Laboratory tests and imaging confirmed a diagnosis of appendicitis. He received IV antibiotics and underwent a laparoscopic appendectomy.
- The clinical pharmacist reviewed the patient's medications and provided recommendations to avoid potential drug interactions and maximize treatment of appendicitis.
This document describes the case of a 3 year old female child presented with huge hepatomegaly, hypoglycemia, and metabolic acidosis. On examination, she had doll-like face and protuberant abdomen with huge hepatomegaly but no splenomegaly. Laboratory tests showed hypoglycemia but normal renal and liver function tests. She had several admissions for severe metabolic acidosis and hypoglycemia. A liver biopsy was performed. The differential diagnoses being considered included glycogen storage disorder (GSD) or fatty oxidation disorder given the presentation of hypoglycemia, hepatomegaly, and metabolic acidosis. Further investigation was needed to make a diagnosis and determine appropriate treatment.
This case presentation describes a 9-month-old male child admitted to the pediatric unit with febrile seizures. He presented with a 1-week history of fever, cough and cold, and experienced 3 seizure episodes lasting 10 minutes each. His condition was diagnosed as complex (atypical) febrile seizures. His treatment included antibiotics, anticonvulsants, and supportive care. Febrile seizures typically occur in children 6 months to 5 years old during fevers caused by infections and resolve on their own without long-term issues.
Shoulder dystocia occurs when the shoulders become lodged inside the mother's pelvis during childbirth, requiring additional obstetric maneuvers to deliver the baby after gentle traction has failed to dislodge the shoulders. Risk factors include maternal diabetes, obesity, and previous shoulder dystocia as well as fetal macrosomia and postmaturity. The HELPER mnemonic outlines the standard management steps to reduce the shoulder diameter and gain space in the maternal pelvis, including calling for help, applying suprapubic pressure, and internal rotation of the shoulders.
This is a case study done by me as a part of my in-service education progamme in my institution...hope this may help all nurses who wants to do a case study.
This document provides a case history for a 2.5 year old female child named Shreya who presented with an enlarged head, vision loss, and seizures. Her developmental history revealed global developmental delay. On examination, she had macrocephaly, hypertonia, and upgoing plantars. Investigations showed communicating hydrocephalus. She has been diagnosed with hydrocephalus, for which the treatment is either medical management to temporarily relieve symptoms or surgical intervention like ventriculo-peritoneal shunt placement.
Nanay Ganda, an 84-year-old female, was admitted to the hospital with complaints of inability to defecate for 4 days and intermittent abdominal pain over the past year. Imaging showed signs of partial intestinal obstruction. She underwent exploratory surgery where a tumor was discovered and removed at the descending colon. Biopsy results of the tumor were pending. Intestinal obstruction can be caused by adhesions, hernias, tumors and other issues. It requires prompt diagnosis and treatment, like surgery, to avoid increased mortality if left untreated.
The document discusses a case study of a 24-year-old female patient named Kalpana Pandit who was admitted to the hospital for cholelithiasis (gallstones). It provides details of her medical history, symptoms, physical examination findings, diagnosis, and treatment plan. The causes and risk factors for cholelithiasis are also briefly explained.
Mrs. Omi Devi, a 67-year-old female, presented with abdominal pain for 12 days and was diagnosed with cholelithiasis after an ultrasound revealed gallstones. She has a history of diabetes and hernia surgery. On physical examination, she had pain in her abdomen on palpation at the site of her recent laparoscopic cholecystectomy. Her lab tests showed elevated bilirubin levels. She is being treated medically with antibiotics and pain medications and was advised dietary and lifestyle modifications to manage her condition.
Pregnancy Induced Hypertension - Pre eclampsiaomar143
This document provides information about a 33-year-old pregnant woman admitted to the hospital with mild preeclampsia at 36 weeks of gestation. It includes her medical history, symptoms, physical exam findings, lab results, diagnosis, and notes on preeclampsia and its management. The key details are that she presented with swelling in her lower limbs and a history of amenorrhea for 8 months, and was found to have elevated blood pressure and mild preeclampsia at 36 weeks of pregnancy.
A 33-year-old male presented with sudden onset weakness of the limbs for 7 hours. He has a history of similar episodes in the summer after excessive work. On examination, he had weakness of proximal and distal muscles of all limbs. Laboratory tests found hypokalemia, metabolic alkalosis, hypomagnesium, and low urinary calcium levels. He was diagnosed with Gitelman's syndrome based on the clinical and laboratory findings. Gitelman's syndrome is an autosomal recessive disorder characterized by hypokalemia, metabolic alkalosis, hypomagnesium, hypocalciuria, and normal blood pressure.
The patient is a 57-year-old female who presented with a rapidly enlarging swelling in her neck accompanied by pain. She has had a history of a multinodular goiter for over 30 years. On examination, her thyroid gland was enlarged bilaterally with the right lobe being larger than the left. She has no other associated symptoms. Her past medical history and family history are unremarkable. She is scheduled for surgery to address the enlarging goiter.
This document provides an overview of inguinal hernias. It defines a hernia as the protrusion of an organ through a weakness in the muscle wall. It then discusses the epidemiology, types, anatomy, etiology, pathogenesis, signs and symptoms, diagnosis, treatment and complications of inguinal hernias. The treatment options covered are herniotomy, herniorrhaphy, and laparoscopic repair techniques like the Lichtenstein method. The prognosis is typically good, though there is a small risk of recurrence.
Acute glomerulonephritis is an acute inflammation of the renal glomeruli characterized by sudden onset of oliguria, hematuria, hypertension and edema. It is commonly caused by a streptococcal infection and results in the deposition of immune complexes in the glomeruli. On pathology, glomeruli appear enlarged and infiltrated by polymorphs with epithelial crescents. Immunofluorescence shows "lumpy-bumpy" deposits of immunoglobulin and complement. Management involves controlling hypertension and edema with diuretics, treating any underlying infection, and managing complications such as acute renal failure. The prognosis is generally good with complete recovery in most cases.
UG CASE PRESENTATION ON INGUINAL HERNIAAyesha Huma
I have added viva notes after this proforma for quick revision of important stuff asked in exam.
LINK FOR EXAMINATION VIDOES :
1. https://youtu.be/uO-w_9w5okI
2. https://youtu.be/Vc_ZH_-Oad4
It usually takes about 6 weeks to recover from your c-section but this will depend on your individual situation. If you had any problems during or after your c-section, or if you’re looking after other children at home, you may feel you need more time to recover.
This document contains information about a 54-year-old female patient named Jubedabivi Bharubhai Kakar who was admitted to the hospital for a total mastectomy due to breast carcinoma stage 3. It includes her medical history, physical examination findings, lab results, diagnosis, treatment plan including chemotherapy and surgery, and nursing care plan. The patient presented with complaints of fever, pain and lump in the left breast, and was diagnosed with breast carcinoma based on biopsy, ultrasound, MRI and mammography results. She underwent a total mastectomy and is being treated with chemotherapy.
A 34-year-old male presented with a 1-year history of a painless, progressively enlarging mass above the umbilicus. Examination revealed a 2x2 cm reducible swelling above the umbilicus that increased in size with coughing. Imaging showed a paraumbilical hernia. The patient underwent hernioplasty using an anatomical repair with mesh placement. Post-operatively, the patient recovered well without complications.
1. This patient presented with periodic paralysis caused by both hyperthyroidism (thyrotoxic periodic paralysis) and renal tubular acidosis. The hyperthyroidism prevented symptoms from manifesting until after delivery when potassium levels dropped further.
2. The initial nerve conduction study showed demyelination likely due to the previous episode being treated as a demyelinating disease.
3. Going forward, the patient will need long-term management of their hyperthyroidism, renal tubular acidosis, and further evaluation for Sjogren's syndrome. Potassium and bicarbonate supplementation as well as thyroid medication will be required.
Obs jaundice for whipple procedure ppt.pptxdeepti sharma
A 52-year-old man presented with progressive jaundice, dark urine, clay-colored stools, and weight loss over 4 months. Examination found icterus and a firm, non-tender lump in the right upper abdomen. Imaging showed biliary duct dilation likely due to a stricture. The working diagnosis was obstructive jaundice possibly due to a malignancy, for which Whipple's surgery was planned. Anesthetic considerations included the patient's poor nutrition and smoking history, as well as concerns related to the long surgery, blood loss, and effects of anesthesia on liver function and blood flow.
- Mrs. Shahnaz, a 40-year-old housewife, presented with 4 days of right upper abdominal pain and 2 days of vomiting.
- On examination, she had tenderness in the right hypochondriac region and Murphy's sign was positive.
- Ultrasound showed cholelithiasis with cholecystitis.
- She was diagnosed with acute cholecystitis and treated conservatively with antibiotics, analgesics, antispasmodics and anti-ulcer medications.
The patient is a 54-year-old male who presents with heartburn occurring up to 4 times daily as well as indigestion and pain on swallowing. Diagnostic tests revealed gastroesophageal reflux disease (GERD) and damage to the esophageal mucosa. His symptoms are likely due to an incompetent lower esophageal sphincter exacerbated by obesity. Treatment involves lifestyle modifications, medication, and potentially surgery if conservative measures fail. Nursing care focuses on pain management, dietary changes, weight loss, and patient education about GERD management.
Mesenteric ischemia presentation by Dr.NOSHI Capital Hospital Islamabad Paki...drfarhanali2008
The document describes a case of mesenteric ischemia in a 36-year-old male patient who presented with lower abdominal pain and vomiting. Key details include:
- The patient reported 4 days of lower abdominal pain that became severe and was accompanied by vomiting for 1 day.
- Examination found abdominal tenderness and guarding. Imaging showed fatty liver and mild ascites.
- Exploratory laparotomy revealed infarcted small intestine requiring a double barrel stoma.
- The patient was optimized after surgery and underwent stoma reversal surgery.
- Mesenteric ischemia occurs when blood supply to the intestine is inadequate and can be acute or chronic, having various etiologies including embol
A 59-year-old Chinese man was admitted to the hospital for vomiting blood. He has a history of hepatitis C and is a smoker, drinker, and former drug user. Physical examination found abdominal distension with fluid thrill and shifting dullness. Testing showed signs of liver dysfunction. The provisional diagnosis is esophageal varices secondary to liver disease, likely cirrhosis. Esophageal varices form as a result of portal hypertension in liver disease and can bleed, potentially severely. Treatment focuses on stopping the bleeding and lowering portal pressure through various medical and procedural options.
This case presentation describes a 60-year-old male with hepatitis C and hypertension who presented with fever, weight loss, and right upper quadrant pain. Imaging revealed a large liver lesion consistent with hepatocellular carcinoma. The patient underwent transarterial chemoembolization (TACE) and was discharged with medications. TACE involves selectively delivering chemotherapy to the tumor along with arterial embolization. The patient will follow up in one week.
This document provides information on evaluating patients presenting with fatigue, weakness, and weight loss. It reviews common differential diagnoses and recommended initial laboratory tests. Four clinical cases are presented and discussed. The first case involves an 80-year-old woman who presented with hematemesis, confusion, and a 10kg weight loss over 4 months. Her initial workup revealed anemia and elevated ESR, suggesting a serious underlying condition needs to be investigated.
This document summarizes the medical examination and diagnosis of a 36-year-old pregnant woman named Khadija. She presented with nausea, morning sickness, and a 4-week history of amenorrhea and was found to be 4 weeks pregnant. She also reported a history of diabetes for 1.5 years. On examination, she appeared ill and anxious with normal vital signs and mild anemia. Laboratory tests confirmed diabetes in pregnancy with elevated blood sugar levels. She was diagnosed with diabetes in pregnancy and a treatment plan was outlined involving insulin, antiemetics, antiulcer medication, and folic acid, with advice on diet, rest, and follow up in 14 days.
This document contains a morning report from a pediatric case involving a 5-year old Saudi girl presenting with abdominal distension, eye puffiness, and loose stool over 8 days. Her initial impression was likely protein losing enteropathy. Investigations revealed hypoalbuminemia and ascites. Imaging showed bilateral pleural effusion and bowel wall thickening. She was ultimately diagnosed with primary intestinal lymphangiectasia based on endoscopy findings. The report discusses protein losing enteropathy causes, pathophysiology of primary intestinal lymphangiectasia, clinical presentation, diagnosis, and management focusing on a low-fat diet with medium-chain triglyceride supplementation.
A 54-year-old Malay woman presented with vomiting after eating and epigastric pain for one week. Physical examination revealed tenderness in the epigastric region and jaundice. Laboratory tests showed elevated liver enzymes and bilirubin. Ultrasound found multiple gallstones. She was diagnosed with cholelithiasis and treated with antibiotics and pain medications.
The document summarizes the case of a 10-year-old boy admitted with fever, jaundice, and abdominal pain. Key findings include intermittent high fever for 4 days, jaundice for 4 days, and occasional right upper abdominal pain. He had a similar prior episode 2 months ago. Examination found him febrile but otherwise stable. Tests showed elevated liver enzymes and bilirubin. Ultrasound and MRCP found a fusiform dilated common bile duct suggestive of a choledochal cyst. He was started on antibiotics and vitamin K. His fever subsided after a few days but jaundice remained. A pediatric surgery consultation was requested.
Mrs. Faiza, a 29-year-old married garment worker, was admitted to the hospital with a chief complaint of fever for 5 days, burning during urination for 5 days, and vomiting for 3 days. On examination, she was ill-looking and anxious with a temperature of 102°F, pulse of 120 beats/min, and blood pressure of 120/70 mmHg. Laboratory tests found anemia, elevated white blood cell count, and urine culture grew Klebsiella bacteria. She was diagnosed with acute pyelonephritis with renal impairment and mild hyponatremia. She was treated with intravenous antibiotics and discharged with advice on hydration and preventing future urinary tract infections.
This document provides an overview of acute pancreatitis including its anatomy, epidemiology, pathophysiology, etiology, clinical presentation, workup, severity scoring, treatment, prognosis, and complications. It begins with definitions of the pancreas' anatomy and functions. It then discusses the disease's worldwide incidence, risk factors, presentations, diagnostic criteria, hematological and radiological evaluations, and key findings on imaging studies like CT scans. The document provides a comprehensive review of acute pancreatitis.
This case presentation summarizes a 48-year-old female patient who presented with jaundice for 4 months, abdominal distension for 1 month, constipation for 4 days, rectal bleeding for 3 days, and altered sensorium for 1 day. Her examination revealed pallor, icterus, edema, ascites, splenomegaly, and hemorrhoids. Investigations supported a diagnosis of acute on chronic decompensated liver disease with portal hypertension and grade III hepatic encephalopathy. Further workup was suggested to determine the underlying cause of cirrhosis such as viral hepatitis, autoimmune disease, or genetic conditions.
This case presentation describes a 35-year-old female who presented with generalized swelling over her body for 20 days and abdominal pain for 1 day. Her history and examination findings were consistent with hypothyroidism, nephrotic syndrome, and systemic lupus erythematosus. Laboratory tests confirmed Hashimoto's thyroiditis, lupus nephritis with nephrotic range proteinuria, and positive ANA, anti-dsDNA, and anti-thyroglobulin antibodies. She was started on prednisone and thyroxine therapy and admitted for further management including a renal biopsy.
Case Presentation for Surgery - PancreatitisAditij4
A 40-year-old male bus driver presented with constant epigastric pain radiating to the back, associated with nausea and vomiting. Examination found tenderness in the epigastric region and signs of shock. Laboratory tests showed elevated amylase levels. The patient was diagnosed with acute hemorrhagic pancreatitis based on his history of alcohol abuse and clinical signs. He required aggressive fluid resuscitation and monitoring in the hospital due to the severity of his condition.
This document contains a case report for a 55-year-old male patient who presented with a 2-day fever and 1-day pain in his scrotum. On examination, his left scrotum was swollen and tender. His medical history includes smoking 30 packs per year and a recent ischemic stroke. Laboratory tests showed elevated inflammatory markers. Imaging found a mass in his lung and lesions in his testicles. The diagnosis was determined to be small cell carcinoma of the lung with epididymo-orchitis, hyponatremia, urinary tract infection, and history of ischemic stroke. He was prescribed various medications to treat his conditions.
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Here is summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
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Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
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3. Particularsofthepatient:
Name: Moynesa Khatun
Age: 45 years
Sex: Female
Occupation: Housewife
Marital status: Married
Religion: Islam
Present Address: Kunia, Targach, Gazipur
Permanent Adress: Mymensingh
Date of admission : 03.11.2019 at 12.30 pm
Date of examination: 03.11.2019 at 01.00 pm
4. Chief complaints:
1. Pain in right upper abdomen for 3
days.
2. Discomfort In upper abdomen for
1month.
3.Nausea for same duration
5. Historyofpresentillness:
• According to the statement of the patient she was reasonably
well 1month back then she developed right hypochondriac
discomfort which was recurrent and was associated with
nausea. Patient stated that the discomfort was more
pronounced after the consumption of fat containing foods. On
further inquiry patient gave history of 2 episodes of sudden
excruciating right hypochondriac pain which was colicky,
radiating to right shoulder, associated with vomiting that was
followed by intake of oily fried food. Pain had no periodicity
and was not associated with fever with chills and rigors. Her
stool is normal and has no history of steatorrhea. She is non
Diabetic, Non-Hypertensive. With these complains she is
admitted to department of surgery of this Hospital for her
better management.
6. Historyof pastillness:
• She has No significant past medical and
surgical history.
Drug history:
• She has History of taken pain killer but she
couldn’t mention name
Family history:
• All other family members of her family are
apparently healthy.
• Personal History:
She is nonsmoker and non betel nut chewer .
7. Menstrual history:
Her menstrual cycle is regular .
Occupational history:
She is a Housewife.
Socioeconomic status:
She belongs to a middle class family.
Immunization history:
She is not fully immunized as per EPI
schedule of her time.
8. General examination:
•Appearance : Ill looking
• Body built : Average
• Co-operation : Co-operative
• Decubitus : On choice.
• Nutrition : Average
•Anemia : Mild
• Jaundice : Present
12. Abdomen proper:
Inspection:
Shape of abdomen : Shape was scafoid
shaped, had normal hair distribution and
wear no visible impulses.
Movement of the abdomen :Moves
with respiration.
Umbilicus : centrally placed,
Inverted and vertical slit
Visible pulsation : Absent
Visible peristalsis : Absent
Scar mark : Absent
13. Palpation:
Superficial palpation:
Temperature : Normal
Tenderness :Soft and slight tender
in Right Hypochondrium
Any mass : Absent
Deep palpation:
Liver : not palpable
Spleen : not palpable
Kidney : not ballotable
Urinary bladder : not palpable
14. Percussion:
Percussion note : Tympanic
Upper border of liver dullness :
Right 5th intercostal space
Shifting dullness : Absent
Auscultation:
Bowel sound : Present
No Hepatic bruit, splenic rub or
renal bruit.
15. Respiratorysystem.
Inspection:
Shape of the chest : Normal
Deformity : Absent
Movement of chest : Normal
Respiratory rate : 18 breaths/min
Any scar marks : Absent
Visible impulse & engorged vein : Absent
16. Position of trachea : Centrally placed
Apex beat : Felt in left 5th intercostal
space just medial to the
midclavicular line.
Chest expansibility : Normal
Vocal fremitus : Normal
Palpation:
17. Percussion:
• Percussion note : resonant
• Upper border of liver dullness : in
right
5th intercostal space in
midclavicular
line.
Auscultation:
• Breath sounds : Vesicular
• Added sounds : absent
• Vocal Resonance : Normal.
18. Cardiovascularsystem:
Inspection:
Deformity of chest : Absent
Visible Cardiac impulse : Absent
Any Scar marks : Absent
Palpation:
Apex beat : Felt in left 5th intercoastal
space just medial to the midclavicular line
Thrill : Absent
Left parasternal heave : Absent
Palpable P2 : Absent
Epigastric pulsation : Absent
19. Auscultation:
Heart sound : 1st and 2nd heart
sounds are audible in all auscultatory
area.
Murmur : Absent
Added sound : Absent
20. Nervoussystem:
Higher psychic function: Intact
Cranial nerve examination: all cranial nerves are
intact
Signs of meningeal irritation:
Neck rigidity: Absent
Kernig’s sign: Negative
Brudzinski’s sign: Negative
Motor function: Normal
Sensory function: Normal
Cerebellar function: Intact
21. Salient Feature:
Mrs Moynesa Khatun, 45 years old
muslim female hailing from kunia targach
,Gazipur was admitted at TMMC&H on
the date 03.11.2019 with complains of
recurrent Right upper abdominal
Discomfort, fatty food intolerance and
nausea since last 1month
22. . On further inquiry she had 2 episodes of
sudden excruciating Right Hypochondriac colicky
pain, radiating to right shoulder, associated with
vomiting which was followed by intake of oily
fried food. Pain has no periodicity and was not
associated with fever with chills and rigors,
patient has no history of steatorrhea. She is non
diabetic.On general examination showed that
patient is non obese while her abdominal
examination revealed that there was slight
tenderness in Right Hypochondrium.
23. .
On general examination, she is co
operative,anaemic and
icteric.Her dehydration,
oedema,cyanosis,clubbing
absent.her pulse 84/m,bp
100/80mmhg,tem 98 F.
Now she is admitted to this
hospital for better management.
40. DURING DISCHARGE;
• 1.Tab Cef-3(200mg)/Cefixime
1+0+1—7days
2.Tab Torax(10mg)/Ketorolac Tromethamine
1+0+1 if pain,after meal -3days
3.Tab Maxpro(20mg)/Esomeprazol Magnesium
Trihydrate
1+0+1 (30 min before meal)-14 days
4.Tab Omidon(10mg)
1+1+1 –5days
41. Advice:
oTake medicines regularly.
oAvoid fatty food.
oYou will have dietary food habits and have
also Vit C enriched fruits except Tamarind.
oIntake plenty of water.
oMaintain proper hygiene
42. Followup
* You will come at 3RD POD for
DRESSING at surgery ward.
• You will come at 6th POD for stitch
off .
•If any complications arise,
consult in OPD of Surgery.
45. Cholelithiasis
• Cholelithiasis is
derived from the
Greek word
‘CHOL’ means
“Bile” and “LITH”
means ‘Stone’.
• Presence of stones
in the gallbladder
is reffered to as
cholelithiasis.
46. Types of Gallstone
• There are three types of gallstone which is given
below:
• CHOLESTEROL STONES( 80% cholesterol by weight)
vary in color from light yellow to dark green or
brown and are oval 2to 3cm in length,often having a
tiny dark center spot.
47. • PIGMENT STONES are small,dark stones
made of bilirubin,calcium salts and 20%
cholesterol that are found in bile.
• MIXED GALLSTONES typically contain 20-
80% cholesterol.Other common
constituents are calcium
carbonate,palmitate phosphate ,bilirubin
and other bile pigments.Because of their
calcium content,they are other
radiographically visible.
48.
49. Pathophysiology:
• Cholesterol gallstones develop
when bile contains too much
cholesterol and not enough bile
salt.
• Two other factors are important in
causing gallstones are:
• Incomplete and Infrequent
emptying of the gallbladder may
cause the bile to become
overconcentrated and contribute
to gallstone formation.
50. •The second factor is the
presence of proteins in the
liver and bile that either
promote or inhibit cholesterol
crystallization into gallstones.
53. Signs and symptoms:
• Gallstones may be asymptomatic,even for
years.These gallstones are called “silent
stones” and do not require treatment.
• Symptoms commonly begin to appear once the
stones reach a certain size(>8mm)
• A characteristic symptom of gallstones is a
“gallstone attack”, in which a person may
experience intense pain in the upper right
side of the abdomen.
54. •Often,attacks occur after a
particularly fatty meal and
almost always happen at
night.
•Abdominal bloating.
•Intolerance of fatty foods.
•Belching.
•Gas
•Indigestion