A 26 year old female with lower back pain,fever,abdominal pain

26 year old female who is a resident of nalgonda and house wife by occupation came with a chief complaints of
Lower abdominal pain since 10 days
Fever since 5 days
Abdominal pain since 1 day
HISTORY OF PRESENT ILLNESS:
Patient was apparently asymptomatic 10 days ago then she developed lower back pain which was insidious in onset and persistent,aggregated during night,no radiation to lower limbs.
      Then she developed fever which was insidious in onset and gradually progressive,which is relieved on medication.It is associated with chills and rigors.
Then she developed abdominal pain in the epigastric region
Patient noticed reddish coloured urine which is not associated with any pain
No history of chest pain,palpitations,syncopal attacks,burning micturition,constipation.
PAST HISTORY:
No similar complaints in the past
Patient had mitral valve replacement done at the age of 7 years
 c-section was done 7 months back.
No history of diabetes,hypertension,asthma,tuberculosis,
Cad.
PERSONAL HISTORY:
Diet: mixed
Appetite:normal
Sleep:adequate
Bowel and bladder:regular
No addictions
No allergies 
FAMILY HISTORY:
No similar complaints in the past
No history of diabetes,hypertension,asthma,tuberculosis,
cad.
GENERAL EXAMINATION:
Patient was conscious coherent and cooperative,well built and we'll nourished.
VITALS:
Temperature:febrile
Respiratory rate:16c/m
Pulse rate:98bpm
Blood pressure:140/70mm/hg
Sp02:99%

Pallor: present
Icterus:absent
Clubbing:absent
Lymphadenopathy:absent
Edema:absent
SYSTEMIC EXAMINATION:
Abdominal examination:
INSPECTION:
Shape:scaphoid
Flanks:free
Umbilicus:central in position and inverted
Skin:normal
No dilated veins
Movements of abdominal wall is normal
No visible gastric peristalsis
Hernial orifices are normal
External genitalia: normal 
Renal angle:
PALPATION:
SUPERFICIAL PALPATION:
No local raise if temperature
Tenderness localised to right lumbar region(renal angle)
DEEP PALPATION:
Liver:palpable 2 cm below right costalmargin.
Spleen:not palpable
Kidney:not palpable
No other palpable swellings
PERCUSSION:
No fluid thrill
AUSCULTATION:
Bowel sounds heard
Bruits not heard
Venous hum not heard.


Popular posts from this blog

28 year old female with right upper and lower limb weakness

Image
A 28 year old female came to OPD with chief complaints of weakness and pain in right lower limb and upper limb since 8 years. HOPI: Patient was apparently asymptomatic 8 years back then she developed weakness in right lower limb which is insidious in onset and gradually progressive,associated with pain.no tingling sensation. Pain in right side of the back radiating to right lower limb and no tingling sensation. Patient also had c/o headache which is on and off since 8 years.holicranial type,no tingling/numbness.no photophobia and no phonophobia. Progressive weakness of lower limb 1st in thigh then extended upto feet. Patient slowly developed difficulty in walking since then with changes in style of gait as weakness progressed in right lower limb. H/o trauma 8 years back-fall from bicycle after which she developed these symptoms. Past history: Patient gives history of trauma due to fall at the age of 5-6 years and had injury to nose and she had epistaxis-last episode was after the deliv
Read more

A 65 year old male with abdominal distention,urinary retention

Image
Short case Name:N.vishnu rohith Reddy Hall ticket no:1701006126 June 11th 2022 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 patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box. A 65yr old male patient who is a resident of nakrekal and farmer by occupation came to the OPD with the chief complaints of   Pedal edema for 2days Abdominal distention for 2 days Shortness of breath for 2 days HISTORY OF PRESENT ILLNESS: Patient was apparently asymptomatic 4 months back,then he developed swelling of legs for which he went to a hospital in nakrekal where he was diagnosed with renal calcul
Read more

28 year old female with right upper and lower limb weakness

Image
A 28 year old female came to OPD with chief complaints of weakness and pain in right lower limb and upper limb since 8 years. HOPI: Patient was apparently asymptomatic 8 years back then she developed weakness in right lower limb which is insidious in onset and gradually progressive,associated with pain.no tingling sensation. Pain in right side of the back radiating to right lower limb and no tingling sensation. Patient also had c/o headache which is on and off since 8 years.holicranial type,no tingling/numbness.no photophobia and no phonophobia. Progressive weakness of lower limb 1st in thigh then extended upto feet. Patient slowly developed difficulty in walking since then with changes in style of gait as weakness progressed in right lower limb. H/o trauma 8 years back-fall from bicycle after which she developed these symptoms. Past history: Patient gives history of trauma due to fall at the age of 5-6 years and had injury to nose and she had epistaxis-last episode was after the deliv
Read more