58 YEAR OLD WITH ASCITES

This is an E log book to discuss our patients de identified health data shared after guardians informed consent.

Here we discuss our individual patient problems through series of inputs from available global online community of experts with an aim to solve this patients clinical problems with collective current best evidence based inputs.

This E-book also reflects my patients centered online learning portfolio and your valuable comments in comment box are most welcome.

I have been given this case to solve in an attempt to understand the topic of "patient clinical data analysis" to develop my competency and to comprehend clinical data including history, clinical finding investigations and come up with a diagnosis and treatment plan.


CHIEF COMPLAINTS 

- Fever since 1 day 

- Vomiting since 1 day 

- SOB ( grade III initially)

HISTORY OF PRESENTING ILLNESS

The patient was apparently alright 1 day ago when she had developed sudden fever insidious in onset, gradually progressive, high grade, not relieved on medication, continuous, associated with chills. She had just come home from her work and took her afternoon nap as per usual when this started. She also developed 2 episodes of vomiting, non projectile water as content. She also developed SOB grade III (MMRC) initially when she walked till the bathroom which was very near and developed SOB and later progressed to grade IV (MMRC). She had not slept all night and she started defecating and urinating in her clothes. In the morning they took her to an RMP who suggested they bring the patient here.
PAST HISTORY

H/O similar complaints in the past almost 9 months ago when the com

FAMILY HISTORY 

No similar complaints in the family 

PERSONAL HISTORY 

DIET: Mixed 
APPETITE: decreased 
SLEEP: adequate 
B&B: Regular
He consumes alcohol socially 
No allergies 

GENERAL EXAMINATION 

The patient was conscious, coherent, cooperative, well oriented to time, place, person. He was moderately built and moderately nourished. 



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