3. Patient came to hospital with complain of Dry
cough,loss of appetite,loss weight and fever
for past 3 months
4. Family history
Personal history
Current medication
H/O OF TB IN FAMILY FOR 7 YEARS
• MIXED DIET
• APPETITE DECREASED
PARACETAMOL
Past history
PATIENT HAS NO HISTORY OF HTN,TB,DM TYPE 2
8. TEST VALUE NORMAL
HEMOGLOBIN 9.19GM/DL 14-18G/DL
NEUTROPHIL 81% 45-75
LYMPHOCYTES 15% 20-45
MONOCYTES 0.2% 0-7
MCH 22.6PG 27-32
ABNORMAL LAB REPORTS:
9. DAY INVESTIGATION
DAY 1
DAY 2
DAY 3
DAY 4
DAY 5
DAY 6
• VITALS ARE MONITORED, FEVER IS
MANAGED
• VITALS ARE STABLE, BP-110/60
• BP-112/72,RR-25/MIN
• VITALS ARE STABLE, NO FRESH COMPLAIN
• VITALS ARE STABLE
• PATIENT IS DISCHARGE
PROGRESS CHART:
12. SUBJECTIVE EVIDENCE
A 20 YEARS OLD GIRL WAS ADMITTED TO THE
HOSPITAL TO PULOMNARY WARD WITH CHIEF
COMPLAIN OF DRY COUGH,LOSS APPETITE,LOSS
WEIGHT,FEVER FOR 3 MONTHS.NO HISTORY OF
TB,HTN AND DM TYPE 2
13. OBJECTIVE EVIDENCE:
PATIENT WAS GETTING MEDICATION PARACETAMOL BEFORE
ADMITTING TO THE HOSPITAL. PATIENT HAS ABNORMAL RESULTS OF,
• ELEVATED HEMOGLOBIN
• ELEVATED NEUTROPHIL
• DECREASED LYMPHOCYTES
• MCH IS DECREASED
• URINE ANALYSIS-KETONES WERE PRESENT
• PALLOR=POSITIVE
14. ASSESSMENT
BASED ON THE SUBJECTIVE AND OBJECTIVE EVIDENCE
LIKE COUGH,FEVER,LOSS OF WEIGHT AND APPETITE AND
OBJECTIVE EVIDENCES LIKE URINALYSIS PATIENT WAS
DIAGNOSED WITH
=TB WITH TYPHOID
15. DRUG INTERACTION
NO DRUG INTERACTIONS WERE FOUND
PLANNING
NON-PHARMACOLOGICAL TREATMENT:
• INCREASED FLUID INTAKE
• LIFESTYLE MODIFICATION
• DIET RICH IN NUTRIENTS
GOALS
• TO REDUCE SIGH AND SYMPTOMS
• TO CURE ONGOING DISEASE
16. DRUGS
BRAND NAME
GENERIC NAME WITH
DOSE,ROUTE
,FREQUENCY
DAY 1 DAY 2 DAY 3 DAY 4 DAY 5 DAY 6
TAB.PARACETAMOL
ACETOMINNOPHEN
500MG,IV,OD
+ + + + +
INJECTION.PANTOP
PANTOPRAZOLE,40MG,I
V,OD
+ + + + +
INJECTION.CEFTRIAXONE
CEFTRIAXONE,1.6GM,IV,
BD
+ + +
TAB.ZINCOVIT MULTINUTRIENT,PO,OD + + +
INJECTION DNS+KC2
DEXTROSE+NACL
,500ML
+ + + + + +
CANDID MOUTH PAINT
CLOTRIMAZOLE
1%W/V,TDB
+ + +
PHARMACOLOGICAL TREATMENT:
17. PATIENT COUNSELLING CARRIED OUT
ON DISEASE:
TB is a bacterial infection that mainly affects the lungs caused by Mycobacterium
tuberculous. Typhoid fever is caused by salmonella typhi a bacteria that spreads
through contaminated food, water
ON DRUGS:
• INJECTION PANTOP-administered through IV, it works as a proton pump
inhibitor and may cause nausea, vomiting
• INJECTION CEFTRIAXONE-administered through IV, works as an antibiotic and
may cause diarrhea, abnormal liver test
• TAB.PARACETAMOL-taken with food,works as a painkiller and may cause
vomiting
18. 4.CANDID MOUTH PAINT-apply directly to infected area,works a
santifungal,may cause blisters,swelling
5.TAB.ZINCOVIT-taken with food,works as multibvitamin
6.INJECTION.dns+kc2-taken through iv,works as fluid replacement
FOLLOW UP DETAILS
FOLLOW UP AFTER 1 WEEK
