GENERAL MEDICINE CASE 7

 October 28, 2021

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28 yrs old female came to opd with chief complain of fever,headache,swelling on the neck and nausea

HISTORY OF PRESENT ILLNESS

patient was apparently asymtommatic 14 days back then she developed fever after taking her COVID VACCINE associated with vomitings for 2 days ( 4-5 episodes/day ) visited RMP took medications and fever subsided 

C/o fever since 3 days with diffuse head ache type associted with nausea

Vomitings ( 2 episodes ) on 1st day of fever

No episodes of vomitings next two days ( only nausea feeling )

No cold , cough ,loose stools

C/o hair loss since 3 days

Weight loss since 3 years

No cold /heat intolerance 

PAST HISTORY

5months back she c/o giddiness and she visited RMP  where she was diagnosed of low BP

Married  at the age of 15yrs

2009 - boy ( c section )

2011 - daughter 

2013 - daughter ( had 2 blood transfusions)

2014 - 1 more transfusion due to less hb% and Tubectomy was done

Mentrual history :

age of Menarche 14 yrs 

Cycles : Irregular menstrual cycles since 2years

Backache present

Stomachache present

Bleeding increased since 2 yrs

PHYSICAL EXAMINATION

No signs of icterus cynosis clubbing edema dehydration malnutrition 

Pallor - present

Lymphadenopathy - present ( cervical )

Temp - 98.5 F

PR - 88 bpm

RR - 17 Cpm

Bp - 110/60mmhg

SpO2 - 98% at RA

Grbs - 141 mg/dl


SYSTEMIC EXAMINATION

Cvs : s1 s2 heard no murmurs

Rs : Nvbs + 

P/a : soft , non tender

Cns : higher mental functions normal

INVESTIGATION


















TREATMENT

Rx : IVF NS,RL @ 50ml/hr
Plenty of oral fluids
T.PCM 500 MG PO/TID
T.OROFER-XT PO/BD
T.ULTRACET PO/QID
T.PAN 40 MG PO/OD
INJ MONOCEF 1GM IV/BD
INJ TAZAR 4.5G IV/TID

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