CBBLE UDHC SIMILAR CASES
52 year old female who is a farmer came to the casuality with complaints of
Shortness of breath since afternoon
Vomitings since afternoon
Pain abdomen since afternoon
Dyspepsia since afternoon
HISTORY OF PRESENT ILLNESS :
Patient was apparently asymptomatic shortness of breath since afternoon( grade 2 to grade 3 ) according to NYHA classification
C/o vomitings ( 3 episodes food particle as content) , non bilious, non projectile
C/o pain abdomen ( diffuse type) associated with loose stools ( 2 episodes ) non blood typed , non foul smelling
C/o dyspepsia since afternoon
PAST HISTORY :
Similar complaints in the past ( was admitted in our hospital and treated 9 months back )
K/c/o DM since 4 years on insulin (HAI -17 U -x-10U)
N/ k / c /o HTN , Asthma , epilepsy , TB
O/E :
Patient is consious , coherent and cooperative
Bp:120/60mm hg
PR ; 112 bpm regular
RR :30 / min
Cvs : s1 s2 +
Rs : BAE +
P/A: soft , non tender
Urine for ketone bodies positive
10pm 1 am 5 am
PH 6.94. 7.25 7.35
PCO2 9.2 19.9 27.8
PO2 125 87 72.9
HCO3 1.9 8.6 15
St HCO3 5.2 12.3 17.4
20/3/22 21/3/22
PH 7.36 7.36
PCO2 27.5 31.0
PO2 80.6 79.5
HCO3 15.2 17.2
St HCO3 17.5 19.2
PROVISIONAL DIAGNOSIS:
Diabetic ketoacidosis secondary to GE
TREATMENT:
I. Inj HAI 6 U / IV /stat to Inj.HAI 40 IU in 39ml NS/IV/once 6 ml/hr
2.IVF - ns and rl @ 125 ml/ hr
3.inj pantop 40mg /IV /OD
4.inj zofer 4mg/iv/od
