Another detailed experience
7/10/2018: Oman - SQUH
St 1 :
abdomen, HSM , CHA , thalathemia
Chest , bronchiactasis vs lung fibrosis
St 2 :
old male patient admitted with h/o vomiting and diarrhoea for 2 days and now he is confused and agitated, investigations given with Na 155 , high urea and creatinine, during taking history when i asked about PMH and Drug history, he had depressive disorder since 11 years and on lithium , so DD is nephrogenic DI VS electrolytes impalance and renal impairment due to vomiting and diarrhea discussion about diagnosis of DI and treatment
St 3
metallic valve , Af??
Neuro , lower limb examination, there is lmnl with hypotonia and hyporeflexia and cerebellar signs
St 4:
it is mentioned that the patient is known case of achalasia and usually have repeated balloon dilation and this time he developed iatrogenic perforation during the prosedure
was iatrogenic oesophageal perforation.
To BBN to the son.
And the son asked not to tell his father about that , and also he want to take his father home, patient competent so he has the right to know about his condition, and i convenced the son to stay in hospital and explained the seriousness of the condition
Questions was about the issues in scenario and what if the patient himself want to go home , what will you do , he want to hear psychiatric assessment
St 5:
BCC 1: fainting attack in
hypertensive pts. not clear scenario and not coperative surrogate
Tuberous sclerosis
BCC2:
Outside they wrote pt came for f/up.
Has kidney problem, HTN and DM
: I asked if any complains, He said lips irritation. And mouth problem
pt is short stature, Pale, obvious gum hypertrophy, with arm fistula
transplanted kidney. On ciclosporin and nifidipine
So this is gum hypertrophy due to his medications