CASE PRESENTATION.pptxxxxxxxxxxxxxxxxxxxx

Case present

1. FEMALE BAY VIRTUAL ROUND DR. RUBIYA TUFAIL

2. BED 32 Patient : Bindia w/o wais khan Age : 28 yrs Complaint : swelling gradually increased in size with no associated features Past surgical and medical history : unremarkable No known Comorbids

3. O/E : Vitally stable 9X6 cm lump in the umbilical region , tender , reducible, smooth margins No overlying skin or temperature SNT Abdomen Bowel Sounds Audible

4. Investigations : Blood CP : H b 8.8 Plts 146 TLC 6.2 USG Abdomen : Anterior Abdominal wall defect Measuring 11.2 cm Plan : Managed all worku Sent all Blis Systemic management

5. BED 33 Patient : Natasha w/o Niamat , Age : 18 years Complaint : P ain in upper abdomen for a month Associated with non-bilious, non-projectile 2-3 episodes of vomiting Past surgical and medical history : insignificant Admitted on 15 th of Sep No known comorbids

6. O/E P atient vitally stable, systemic examination unremarkable SNT Abdomen, Bowel sounds audible Murphy’s sign negative

7. Investigations Blood CP TLC 7.4 HB 12.4 Plts 227 Rest of the BLIs : Normal USG Abdomen : echogenic poly sized 2.3 mm and normal wall thickness CXR : Normal

8. Diagnosis : Gall Bladder Polyp No A/C Plan : Repeat ultrasound requested today (a week after admission) and plan accordingly

9. BED 34 Patient : Rasheeda w/o Ejaz ul Haq Age : 58 years Complaint : lump in left upper thigh, 5 years back, gradually increasing in size and painful No known co morbids

10. O/E 3X3 cm on medial aspect of upper thigh, tender, mobile, firm, smooth margins, no overlying skin or temp changes Regional LNs palpable SNT Abdomen and Bowel sounds audible Vitally stable

11. INVESTIGATIONS Blood CP : Hb 12.8 Plts 198 TLC 6.5 Other BLIs : Normal CXR : Unremarkable USG : unremarkable FNAC : Malignant Neoplasm

12. Diagnosis : Metastatic lump? Plan Date for MRI taken: 21 st Sep Date for CT Scan taken: 27 th Sep Vitals monitoring

13. BED 36 Patient : M. Jan Age : 70 years Complaint : SOB, cough and fever for 1.5 mo Systemic Inquiry : unremarkable Known Diabetic

14. O/E : Vitally stable, B/L reduction in right lung air entry UOP: Chest Tube Placed Drain Output: 50 ml in 24 hrs Investigations : Blood CP : Hb 11.2 Plts 372 TLC 7.5 Other BLIs : Normal Pus C/S: unremarkable PFts : Reduced FVC Echo and Ecg : Unremarkable

15. Current management Inj Moxifloxacin Inj Tineum Inj Insulin IP/OP Monitoring BSR monitoring CECT: Dated for 26 th sep Follow up

16. BED 37 Patient : Parveen w/o Ishtiaq Age : 58 years Complaint : pain epigastrium and non bilious non projectile vomiting Systemic history unremarkable No known C omorbids

17. O/E Vitally stable, SNT abdomen and bowel sounds audible Investigations Blood CP : Hb 11.4 Plts 31.5 TLC 8.7 Other BLIs : Normal USG Abdomen : Stones in Gall Bladder Echo : unremarkable CXR : unremarkable Hep B,C : negative

18. Diagnosis: Cholelithiasis Plan: Dated and investigated case for laparoscopic cholecystectomy

19. BED 38 Patient : Munfia w/o Khalid Age : 50 years Complaint : Pain in epiaastrium for 5-6 months radiating in the whole abdomen with no associated features Systemic History : unremarkable No known Comorbids

20. O/E: Vitally stable, SNT Abdomen, Bowel sounds audible Investigations: Blood CP : H b Plts TLC Other Blis : Normal ECG and Echo : Unremarkable USG Abdomen : Stones in Gall Bladder

21. Diagnosis: Cholelithiasis Plan : D ated and Investigated case for Laparoscopic cholecystectomy

22. THANK YOU