A 30-year-old female was admitted to the hospital with diagnoses of thyrotoxicosis secondary to Graves' disease and pneumonia. On physical examination, she had a fever and coarse crepitations in her right lower chest. Laboratory tests showed elevated white blood cell count and thyroid function tests. She was started on medications including PTU, propranolol, antibiotics, and was referred for surgical and ophthalmology consultations.

1. DPT OF INTERNAL MEDICINE
MORNINIG SESSION

2. TIFICATION  DATE OF ADMISSION 230/9/15
 Age 30
 SEX Fm
 MRN 676530
 Address
ssion
nosis
 P1-Thyrotoxicosis 2° Graves disease
 P2- pneumonea
HU CHMS SOM Dpt of Internal medicine 2
Case 1
8/18/2023

3. 8/18/2023 HU CHMS SOM Dpt of Internal medicine 3

4. Objective Evidence
HU CHMS SOM Dpt of Internal medicine
4
PHY EXAMINATION
RS
 Caurse creptation over right
lower 1/3 chest
GUS
GA ASL
Vital signs
BP 117/62
PR 90
CVS
 PMI is palpable at 5th
ICS medial to MCL
 S1 & S2 well heard No
M & G
RR 36
T 36.2
HEENT
ABD
 scaphoid and moves
with respiration
 no organomegally or sign of
fluid collection
IGS
Pink conj and N/S
Bilateral eye balls are
protruded
MSS  No edema,rash or
descrepancy
CNS  COPPT
LGS
no LAnP
there is 7*8cm
ANM that moves
wiht swallowing
8/18/2023

5. date /2015
wbc 11.6k N 74 BIL T Urinalysis
hg 8.6 BIL D
mcv 74 Serum albumin
RDW HgA1C
PLT 364K LDL
Esr 5.1
Cr 0.7 HDL
BUN 19 TGCr
Na 130 Tot chol
K+ 4.78 TSH <0.1
Cl 113 Ft4 66 RBS-139
Cai 0.89 Ft3 >50
AST 57 PT
ALT 43 INR
ALP PTT
8/18/2023 HU CHMS SOM Dpt of Internal medicine 5

6. 8/18/2023 HU CHMS SOM Dpt of Internal medicine 6

7. 8/18/2023 HU CHMS SOM Dpt of Internal medicine 7

8. • PTU 100mv po TID
• Propranolol 40 mg PgO BID
• Augumentin 625 mg POTID
• Doxcycycline 100 mg PO BID
• PCM 1 gm PO PRN
• Consult surgical side
• consult ophtalmology side
8/18/2023 HU CHMS SOM Dpt of Internal medicine 8