Self reflective writing on their medical student career .

 Self reflective writing on their medical student career 



 I AM P.KHYATHI Of the 2018 batch presently an INTERN.



This is an online e-log book to discuss our patient's de-identified health data shared after taking his / her / guardian's signed informed consent. Here we discuss our individual patients' problems through a series of inputs from the available global online community of experts to solve those patients' clinical problems with collective current best evidence-based information.



This E blog also reflects my patient-centered online learning portfolio and your valuable input in the comment box is welcome. 



https://pallikhyathi113.blogspot.com/2023/10/63yr-old-male-complaints-of-fevercough.html 


This is P.Khyathi, posted in the medicine department , when I saw this case it was our OP day and patient presented with the  complaints of fever,cough since 1 months and difficulty in breathing since 2 days 
HOPI : 
Patient was apparently asymptomatic 1 month back and then developed fever intermittent low grade relieved on taking medication associated with chills and rigor 

C/o cough since one month associated with sputum sometimes 

C/o difficulty in breathing since 2 days

Past history

K/C/O CAD Post PTCA status 8 yrs back 

K/C/O HTN since 3 months but not on any medication 

H/o blood transfusion 8 days back - 1 PRBC ,

N/K/C/O DM , CVA , Asthma , TB, Epilepsy

Personal history

Diet : mixed 

Appetite: normal 

Sleep : adequate 

Bowel and bladder : regular 

Addictions: 

Alcohol - used to consume alcohol stopped 15 yrs back 

H/o smoking + but stopped 15 yrs back 

General examination: 

Patient is c/c/c well oriented to time place person

He is ill built and nourished 

At the time of OP his temperature was around 101F and advised for admission 
And patient was kept in AMC 
- Hourly temperature was monitored and according to the temperature he was put on INJ NEOMOL 

Vitals : 
Temperature - 101 F @4pm 

                           100 F @5pm 

                           98.7 @6pm 


                           FEVER CHART 


BP- at 4:15pm 110/60mmHg 

 5:45pm 70/30mm hg 

As the patient is going to hypotension we've started him on Noradrenaline infusion 

6pm 80/40mmhg(noradrenaline 4ml/hr ) 

6:45pm 70/40mmhg (ND - 6ml/hr) 

7:30pm 70/50mmhg (ND - 8ml/hr) 

8pm 120/80mmhg (ND - 8ml/hr) 

9pm 120/80mmhg(ND- 7ml/hr) 

10pm 120/80mmhg (ND - 6ml/hr) 

11pm 120/80mm hg (ND- 4ml/hr) 

12am 130/70mmhg (ND - 3.5ml/hr) 

1am 120/80mmhg(ND- 3ml/hr) 

2am 130/80mmhg(ND-2.5ml/hr) 

As the BP is being maintained we slowed tapered Nor adrenaline infusion . 

PR - 96bpm 

RR - 16cpm 

CVS - S1 S2 heard no murmurs

RS - BAE PRESENT NVBS HEARD

P/A -Soft , non tender 

CNS -NFND  

To evaluate  the cause of fever we ve done the following investigations : 











Treatment: 

IV fluids : UO + 30ml/hr 

Inj.NORADRENALINE (6ml/hr IV infusion ) increase /decrease according to BP - 0.16mg = 1 ml 

Tab. ROVASTATIN + CLOPIDOGREL PO/HS (75MG + 10 MG ) 





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