VELPULA PRANITHA ROLL NO 170

A 14 yr old girl came to opd with CHIEF COMPLAINTS : Shortness of breath since 2 days  Vomitings since 2 days Fever since 2 days History of presenting illness: Patient was apparently asymptomatic 2days ago thn she developed Shortness Of Breath which was insidious in onset, gradually progressive from grade 1 to grade 4,not associated with orthopnea,PND FEVER which was insidious in onset, high grade ,continuous,no diurnal variation associated with chills n rigor VOMITINGS which was 

A 40 yr old male came to opd with  CHIEF COMPLAINTS : yellowish discoloration of eyes and nails since 1 month Abdominal distension since 4days HOPI: Patient was apparently asymptomatic 1 mnth ago then he developed yellowish discoloration of scelra and nails beds which was insidious in onset,gradually progressive,first he noticed on sclera then over nail beds not associated with itching of skin,pale stools. Abdominal distension which was insidious in onset, gradually progressive,diffuse type associated with shortness of breath(insidious , gradually progressive,grade 2 )no h/o orthopnea,PND,sweating, palpitations,chest pain No h/o nausea,vomitings,joint pains, fatigue, burning micturition. PAST HISTORY: no history of similar complaints in the past. No h/o DM,HTN, epilepsy,asthma,TB NO history of blood transfusion PERSONAL. HISTORY: Diet- mixed Appetite -normal Sleep-adequate Bowel n bladder - normal Addictions- alcoholic since 20 yrs (90ml/day) Abstinence since 2 mnths FAMILY HISTORY : n

 A 38 yr old male patient ,resident of Suryapet, labourer by occupation came with CHIEF COMPLAINTS: FEVER SINCE 10 DAYS                                        SHORTNESS OF BREATH SINCE 1 WEEK HISTORY OF PRESENTING ILLNESS: Patient was apparently asymptomatic 10 days ago then he developed FEVER which was insidious in onset, intermittent,high grade, evening rise of temperature,no seasonal variation Associated with chills and rigor,body pains, burning micturition,fatigue headache NOT ASSOCIATED WITH nausea, vomiting,rashes  COUGH was dry, intermittent,no diurnal variation,no seasonal variation not associated with chest pain and abdominal pain since 10days COLD was insidious,no post nasal drip ,no difficulty in swallowing,no sore throat,no ear discharge since 10days SHORTNESS OF BREATH was insidious in onset,grade 2 type(mmrc), progressive on exertion, relieved on taking rest not associated with paroxysomal nocturnal dyspnea, orthopnea,chest tightness since 1week PAST HISTORY:Diabetic sinc

 A 75 yr old male ,resident of suryapet,lorry driver by occupation came with  CHIEF COMPLAINTS: SHORTNESS OF BREATH since yesterday HISTORY OF PRESENTING ILLNESS: Patient was apparently asymptomatic 1week ago thn he developed FEVER which was insidious in onset,high grade, intermittent,with diurnal variation,no seasonal variation relieved on medication not associated with chills and rigor,rashes,nausea, vomiting, headache,blurring of vision,body pains,joint pains COUGH with sputum insidious in onset, continuous,productive,blood tinged non purulent,mucoid type scanty in amount,with diurnal variation not associated with chest pain, abdominal pain SHORTNESS OF BREATH which was insidious in onset, gradually progressive from grade1 to grade 4 associated with paroxysomal nocturnal dyspnea No h/o orthopnea,chest tightness  No h/ o chest pain, palpitations, sweating No h/o pedal edema No h/ o decreased urine output,burning micturition PAST HISTORY: Known case of TB since 10 yrs taken ATT medica

 A 63 year old male patient , resident of narketpally,labourer by occupation came with CHIEF COMPLAINTS:  CHEST PAIN SINCE 2 DAYS SHORTNESS OF BREATH SINCE 2 DAYS HISTORY OF PRESENTING ILLNESS: Patient was apparently asymptomatic 2 days ago then he developed CHEST PAIN - Heaviness in the chest,insidious in onset,dull type of pain on exertion radiating to left hand and shoulder since 2 days SHORTNESS OF BREATH was sudden,not progressive,grade 2(nyha), aggregating on exertion, relieving on resting since 2 days H/o easy fatigability since 2 days No h/o giddiness,nausea, vomiting , headache, sweating  No h/o extertional dyspnea,orthopnea,paroxysomal nocturnal dyspnea, palpitations,postural hypotension No h/o pedal edema No h/o burning micturition , decreased urine output No h/o blurring of vision,tingling sensation,numbness PAST HISTORY: HYPERTENSIVE SINCE 6years on medication Amlodipine Diabetic since 6years on medication Metformin No h/o Asthma, epilepsy,thyroid disorders,TB CAD,CVS FAMI

 A 38 yr old male resident of suryapet farmer by occupation came with CHIEF COMPLAINTS: Shortness of breath since 2 months                                        Pedal edema since 2 months HISTORY OF PRESENTING ILLNESS: Patient was apparently asymptomatic 3 yrs ago then he developed VOMITINGS which is non projectile,non bilious,3 episodes,copious in amount for 2 days relieved on medication not associated with fever,sweating,giddiness,syncope, headache DIFFICULTY IN SWALLOWING associated with throbbing type of pain and halitosis for this he went to hospital there he was diagnosed as tonsillitis .After Using unknown medication for 1 year he had undergone tonsillectomy 2 years ago.During this he was diagnosed as hypertensive as his BP was 180/100  He had an accident 2 years ago.Amputation of right leg below knee was done  and during this he came to know his serum creatinine was 5.6 and HB=6.2 (4 units of blood transfused thn HB= 9)  After 2 months of resting he went to hospital n advised