48/F with AKI secondary to dehydration

Case of 48/F AKI secondary to dehydration  (Hypovolemic shock )  associated with alcoholic ketoacidosis. 

Wenickes encephalopathy?? 




Name: Raveela

Roll. No: 95

Case discussion:

Chief complaints: sob : 1 day, 

      K/c/o  : DM since 6yrs

HOPI: patient was apparently asymptomatic 4 days back then  developed sob  grade  :4 since 4 days , not a/c with orthopnea and Pnd 

vomiting 15 to 20 episodes 2days back which was non projectile  and non bilious and was watery in consistency and contents was food a/c. Pain abdomen, 

fever 2 days back which is low grade  intermittent and not acc. With chills and rigor,  

Past History:

K/c/o DM since 6 yrs( Glimi M2) 

K/c/o  asthma since 4 yrs

K/c/o  pulmonary kochs 3 yrs back and took( ATR) for  6 months 

Personal History:

Diet: mixed

Appetite: Dec. Apettite  since 3 days

Bowl and bladder : Bowl  irregular since 2 days

Sleep :  adequate

Addictions: she used to  take toddy Earlier. Since is consuming alcohol


General Examination:

Patient was  thin built, drowsy, but arousable , dehydrated

No pallor, icterus, cyanosis, lymphadenopathy, edema

Vitals :

B. P: not recordable

P. R:110 bpm

R. R: 30 Cycles/min



Spo2: 98%

Grbs :222mg/dl

Systemic Examination:



R. S:  Dysnea present, no wheeze ,bae+ ,NVBS heard

Cvs: s1s2 heard

PA  :soft and non tender, sluggish bowl sounds. 

CNS : GCS : E4V2M5

INVESTIGATIONS:

CBP


CUE:



ECG



Provisional Diagnosis:

AKI secondary to dehydration ( hypovolemic shock) with DKA H/o pulmonary kochs 3 yrs, 

Asthma : 4 yrs back, Diabetes mellitus: 5 yrs


Treatment. 21/10/21







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