30 year old male, 10 day history of diarrhoea and reduced oral intake, presented with lethargy and ongoing abdominal cramps. No respiratory symptoms, but O2 sats noted to be on the lower side, exertional O2 sats dropped to 86%. No past medical history of note, normal white cell count, not lymphopenic, urea 18.9 mmol/L, creatinine: 489 µmol/L, amylase 600 (30-118), ALT: 65, CRP: 100, Trop I 267 (0-46). Chest X-ray as shown. What do you think the patient is suffered from?
Cardiomegaly Emphysema ARDS
Cardiomegaly Rest. X Ray normal
Myocardial ischemia. Pancreatitis. CRF. Pmemonitis
Pancreatitis , myocarditis with pneumonitis Adv Viral markers
Can Emphysema Cardiomegaly B/L middle & lower lobe pneumonitis Ground glass appearance Rt side collapse consolidation lower zone paracardic region ARDS ? COVID infection
Rt paracardiac lobulated opacity seen. Kerleys line seen. Rt middle lobar atelectasis/ consolidation/ myocarditis. Adv Echo CD and CT thorax.
AGE with pancreatitis with MI D/d atypical presentation of Covid 19
Cardiomegaly Rt paracardiac border hazziness Chest xray is presenting ground glass appearance Rt trachea pulled to rt Lab investigations are raised amylase and creatinine crp deranged Lfts enzyme Trop i +ve sp02 86% This picture suggest myocarditis with pancreatitis Likely complications of covid19 infection
Cardiomegaly dd mass inrt lower base hrct 2 decho trop i positive myocardial infarction with heart failure pancreatitis
Rt parAhilar shdow present
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42M,progressive cough,dyspnea gr4,since 8days, travelled to kerala recently.spo2 84%on nasal 02.HR130,BP110/60,newly ムT2DM.whats possible diagnosis and treatment?
Dr. Sandeep Ghodekar4 Likes26 Answers - Login to View the image
THE COVID-19 SYMPTOMS WE DID NOT KNOW ABOUT As the pandemic spreads around the world, doctors are beginning to scope the coronavirus’s damage. Seen initially as a cause of viral pneumonia during the chaos of an explosion of cases in China, it’s now emerging as an enigmatic pathogen capable of harming the body in a myriad of unexpected, and sometimes lethal, ways. Clinical manifestations range from common cold-like symptoms and bronchitis to more severe disease such as pneumonia, severe acute respiratory distress syndrome, multi-organ failure and even death. The illness may occur as a direct result of viral infection, as well as the body’s response to it. Here’s a snapshot of some of the symptoms Covid-19 causes, including some you might not have heard about. Blood Fever and inflammation may disrupt blood vessels, rendering blood cells more prone to clumping while interfering with the body’s ability to dissolve clots. That may trigger a clotting cascade that can lead to blood-vessel blockages in tissues and organs throughout the body. Life-threatening clots in the arteries of the lung, known as pulmonary emboli, may occur even after symptoms of the infection have resolved. Damaged blood vessels may become leaky and prone to bleeding. In children, inflammation of veins and arteries triggered by excessive immune activation may cause an illness similar to Kawasaki disease, an inflammatory disorder. Brain Dysfunction in the lining of blood vessels and associated bleeding and clotting disorders may cause strokes and bleeding in the brain. Patients may also experience headache, dizziness, confusion, impaired consciousness, poor motor control, delirium and hallucinations. Eyes Red, puffy eyes, sometimes referred to as pink eye, may result from infection in the conjunctiva, the tissue that lines the inside of the eyelids and covers the white part of the eye. Gastrointestinal tract Infection of cells lining the digestive tract may cause diarrhea, nausea, vomiting and abdominal pain. Blood-vessel blockages caused by abnormal clotting have been found to damage the bowel, requiring emergency surgery and resection. Hands Prickling or burning sensation in the hands and limbs may indicate Guillain-Barré syndrome, a rare nervous-system disorder that may be triggered by aberrant immune responses to viral infection. Other symptoms of the syndrome include poor coordination, muscle weakness and temporary paralysis. Heart Cardiac injury, sometimes leading to irregular heartbeat, heart failure, and cardiac arrest, may occur as a result of excess strain, inflammation of the heart muscle and coronary artery, blood clots, and overwhelming multi-organ illness. Infection, fever, and inflammation in people with existing heart-vessel blockages may cause their fatty plaques to break off, blocking or stopping blood flow in organs and tissues. Limbs Obstructions in large blood vessels may cause insufficient flow, or acute ischemia, in the limbs. Severe vascular complications can be lethal. At least one reported cases resulted in lower limb amputation. Liver Liver dysfunction may occur as a direct result of the viral infection, or more likely because of immune-mediated, systemic inflammation and circulatory blockages cutting blood flow to the organ. Lungs The virus targets the epithelial cells that line and protect the respiratory tract as well as the walls of the tiny grape-like air sacs, or alveoli, through which gas exchange occurs to oxygenate the blood. Damage to alveoli and inflammation in the lungs can cause pneumonia, characterized by chest pain and shortness of breath. In severe cases, the lack of oxygen can trigger acute respiratory distress syndrome, leading to multi-organ-system failure. Kidneys Acute kidney injury may result from clots and impaired blood supply, or as a direct result of infection. Nose and tongue While the virus can cause the sneezing and runny nose typical of a common cold, it can also disrupt the olfactory system, causing an abrupt full or partial loss of the sense of smell known as anosmia. Taste may also become distorted in a condition known as dyguesia. Skin Hive-like rashes, small red dots and purplish discolorations on the legs and abdomen are part of a complex category of so-called paraviral dermatoses that may result from the body’s immune response to the virus or from benign, superficial blood-vessel damage beneath the skin. Toes Purple rashes that resemble chickenpox, measles or chilblains may appear on the feet, especially of children and younger adults.
Dr. Prashant Vedwan21 Likes24 Answers - Login to View the image
Dyspnea It is normal with all of us when we exert excessively.. But Dyspnea that is greater than expected with the degree of exertion... is a symptom of disease. Most cases of dyspnea result from asthma, heart failure and myocardial ischemia, chronic obstructive pulmonary disease, interstitial lung disease, pneumonia, or psychogenic disorders.. Below mentioned are the pathological causes of Dyspnea by Organ System…. CARDIO-VASCULAR… Pulmonary edema Acute valvular disease Myocardial infarction Cardiac tamponade Heart failure Angina Constrictive pericarditis RESPIRATORY… Acute exacerbations or persistent chronic asthma Acute exacerbation or persistent chronic obstructive lung disease Pulmonary embolism Pneumothorax Pneumonia ARDS Anaphylaxis COPD Asthma Interstitial lung diseases Pulmonary hypertension Malignancy (tumor related obstructive lesions and lymphangitic spread) Pleural effusions Sleep apnea Foreign body aspiration GASTROINTESTINAL/HEPATIC Acute liver failure and its consequences Abdominal distention of various causes Ascites Portopulmonary hypertension Hepatopulmonary syndrome RENAL CAUSE Acute or chronic renal failure and its consequences HEMATOLOGICAL… Hemorrhage Anemia NEUROMUSCULAR High cervical cord lesions Trauma to phrenic nerves Central apneas Myasthenia gravis Myopathies Amyotrophic lateral sclerosis ENT cause Vocal Cord Dysfunction Laryngeo-tracheal obstruction PSYCHOGENIC BREATHLESSNESS I hope this list of causes will be HELPFUL to diagnose the aetiology of DYSPNEA…
Dr. K N Poddar21 Likes22 Answers - Login to View the image
51/Male with history of cough / dyspnoea/ Giddiness and chest discomfort since 1 week Known HTN BP 150/90 Spo2 : 98% attached ECG AND XRAY
Dr. Delvin Blesso0 Like12 Answers - Login to View the image
34yrs/M admitted with C/o Generalized bodyaches,3 day history of on and off fever which is temporarily relieved by paracetamol,Hypogastric pain,He also experienced nausea and vomitting with loss of appetite.NO PETECHIAE OR RASES present over body.He was tested negative for COVID 19 but positive for dengue.On day 2 admission patient developed dry cough and mild difficulty in breathing. NEED SUGGESTIONS? *Chief Complaints* Fever,bodyaches,NV, Abdomen pain *History* No relevant medical history *Vitals* BP - 120/80,HR -110,Temp -99°F,Spo2 -98% without O2 support,RR - 18 *Investigations* COVID - RT PCR - NEGATIVE DENGUE IGg - Positive Platelet counts -4000,Hb -12,TLC -12000 HRCT chest enclosed
Dr. Prashant Vedwan6 Likes21 Answers
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