CASE SCENARIO 7
CASE REFERENCES -
65 F, homemaker, came with the chief complaints of ALTERED SENSORIUM and
- Fever - which is insidious in onset, low grade w/o chills and rigor, intermittent type since 2 days
- Loose Stools - watery, mucoid, non-blood stained, 10 EPISODES/DAY, w/o pain abdomen since 2 days
- Vomitings - 1 episode, with food as content, non bilious
- Reduced Urine Output - Since 2 days, not associated with burning micturition
- Facial Edema - Since 1 day
ANALYSIS -
Acute GI condition, possibly, Food Poisoning, leading to diarrhea, causing DEHYDRATION, leading to hypovolemia, and acute kidney injury/acute exacerbation of chronic kidney condition due to hypovolemia.
Pt might have been in an altered sensorium owing to the electrolyte imbalance due to dehydration followed by kidney injury.
FINDINGS ON PHYSICAL EXAMINATION -
FINDINGS ON PHYSICAL EXAMINATION -
- Pt was unconscious
- BP - 50/20 mm of hg
- PR - 67 bpm
- RR - 20cpm
- GRBS - 147 mg/dl - prediabetic ?
- Stabilization of the patient's vitals becomes a priority in such cases.
ANALYSIS -
ANALYSIS -
Pt is unconscious with hypotension, bradycardia, tachypnoea ; with a h/o dehydration and kidney dysfunction.
MECHANISM OF THE ABOVE -
MECHANISM OF THE ABOVE -
DIARRHEA
|
LOSS OF FLUID AND ALKALI [BICARBONATE] FROM THE INTESTINES
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HYPOVOLEMIA AND ACIDOSIS
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DECREASED RENAL BLOOD FLOW AND GRADUAL FAILURE OF COMPENSATORY MECHANISMS
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PROTEINURIA DUE TO KIDNEY INJURY
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HYPOVOLEMIC SHOCK PRESENTING WITH ALTERED MENTAL STATUS, HYPOTENSION, BRADYCARDIA AND TACHYPNOEA
MANAGEMENT -
- Immediate fluid replacement
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