CLINICAL MEET 21 ST DECEMBER Department of Medicine Chaired by Dr. - - PowerPoint PPT Presentation

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CLINICAL MEET 21 ST DECEMBER Department of Medicine Chaired by Dr. - - PowerPoint PPT Presentation

Jan 17, 2023 231 likes •482 views

CLINICAL MEET 21 ST DECEMBER Department of Medicine Chaired by Dr. Rakesh Biswas Professor of General medicine Dr. Sarat EVENTS BEFORE HOSPITALIZATION 50Y Abdominal distension 46Y (2017) Diabetes 45Y (2014) EVENTS OF LIFE

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SLIDE 1

CLINICAL MEET

21ST DECEMBER

Department of Medicine Chaired by

  • Dr. Rakesh Biswas

Professor of General medicine

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SLIDE 2
  • Dr. Sarat
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SLIDE 3

Marriage (1993) Divorce (1994) Worked at HYD (1997- 2007) Schizophrenia diagnosed (2009) Menopause (2013) Diabetes (2014) Abdominal distension (2017)

EVENTS BEFORE HOSPITALIZATION

Birth 1968 25Y 26Y 28 to 38Y 41Y 45Y 46Y 50Y

EVENTS OF LIFE AGE AND YEARS

  • Dr. Azra
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  • Dr. Spandana
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SLIDE 5
  • Dr. Spandana
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SLIDE 6
  • Dr. Spandana
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SLIDE 7
  • Dr. Spandana
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SLIDE 8

Risk of malignancy indices(RMI) in preoperative evaluation of adnexal masses

  • Dr. Sahithi
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SLIDE 9
  • Dr. Sahithi
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GENERAL PHYSICIAN CALL FOR HYPOTENSION ON DAY 4 OF ADMISSION

DAY 1 ADMISSION BP – 90/60 mmHg DAY 4 ADMISSION BP- 70/50mmHg. Complaints of diarrhea Signs of dehydration present ? HYPOVOLEMIA TREATMENT: INTRAVENOUS FLUIDS GIVEN

  • Dr. Siphora
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SLIDE 11
  • PRE OPERATIVE BP- 90/60mmHg
  • INTRA OPERATIVE BP -fell down to 60/40mm Hg
  • Inotropes- nor adrenaline and central line was secured and 1

unit of whole blood was transfused

  • POSTOPERATIVE DAY - 1 BP -120/70 mmHg on inotropes
  • Inotropes was weaned off on pod-2
  • CVP not mentioned
  • Dr. Siphora
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GENERAL PHYSICIAN CALL FOR HYPOTENSION WITH BP 80/50 mmHg POD 3

  • CENTRAL VENOUS PRESSURE WAS 4CM OF

WATER

  • TREATED AS HYPOVOLEMIA:

INTRAVENOUS FLUIDS GIVEN WITH CVP MONITORING

  • PATIENT DISCHARGED WITH BP -100/60

mmHg

  • Dr. Siphora
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PATIENT SECOND VISIT AFTER 2 MONTHS FOR TOTAL HYSTERECTOMY WITH SALPINGO- OOPHORECTOMY TO SURGERY DEPARTMENT

  • C/O Weight loss and loss of appetite
  • With BP-70/50mmHg and was put on central
  • line. Fluids and inotropes were started
  • Dr. Siphora
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GENERAL PHYSICIAN CALL FOR HYPOTENSION DAY 2

  • Inotropes were weaned off
  • CVP -3cm of water and IVC diameter 1.3cm
  • Continuous CVP monitoring and IV FLUIDS

accordingly given.

  • Patient was taken up for surgery with BP – 90/60

mmHg

  • Dr. Siphora
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SLIDE 15
  • INTRA OPERATIVE BP -90/60mm Hg was

maintained with IV fluids.

  • POST OPERATIVE BP – 90/60 mmHg
  • PATIENT DISCHARGED BP – 100/60 mmHg
  • Dr. Siphora
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  • Dr. Babji
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SLIDE 17
  • Dr. Babji
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  • Dr. Shweta
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  • Dr. Shweta
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5453/1 7

  • Dr. Shweta
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How does body react to stress?

  • Behavioural sensitization to

stress.

  • Biological mechanisms :

1.HPA axis dysregulation 2.Dopamine dysregulation

  • Dr. Afeen
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MANAGEMENT OF OVARIAN TUMOR

STAGE 1 A [CLEAR CELL CA OF OVARY] TAH + BSO NO NEED OF CHEMOTHERAPY MONITORING WITH CA125 VALUES

  • Dr. Sahithi
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