Heart failure updated managment updated f

Case presentation on heart failure updated managment

1. Morning session Dr.Betrearon

2. Icu 55yrs old pt P1-Advanced HIV disease P2-PTB+?TB meningitis +R/O ICSOL P3-Moderate anemia of CD P4-Esophagial Candidiasis 55 yrs old ptwith newly dx RVI present with chief complain of decrease in mentation of 2 day duration.associated with this he had also globalized dull aching headache of 2 wk duration.for the past 1 wk he had no voluntary control of urination and defication. For the past 3 month he had productive Cough with non bloody sputum., night sweet, low grade intermitent fever,significant unquantified wt loss. He is field worker , drinks alchol usually sometimes to level of intoxication. He had no previous similar sx, contact with chronically coughing person.

3. Pe ASL in pain Bp 120/80 Pr 71 temp 38.8 oxy 98 on atm air Rbs 120mg /dl HEENT-Nis PC,no nasal or ear discharge seen. LGS no lap Chest clear CVS -NM NG Abd full moves with respiration No organomegally MSK-no deformity CNS-Confused 14/15 Pupil bilateral small szed..lefr larger than rt with reactive to light.rt non reactive. Neck rigidity +

4. Lab Cbc wbc 9k N 60% Hg 9.8 Plt 225 Rft,LFT,elt, normal CRP 126, ESR 90mm/hr Cxr, Brain MRI pending

5. Mx Ceftriaxon Vancomycin Ampcilline Dexametason Clotrimazole Pcm Omeprazole UFH Urinary chateter Anti TB-planned

6. Surgical ward 58/M TURP + Bougie dilation was done for BOO 2ry to BPH + meatal stenosis
42/F excision was done for Lt Shambllin II/III Carotid body tumor
78/M TURP was done for BPH
44/M Fistulotomy for low anal fistula and silk seton insertion for communicating sinus tract (Complex fistula in ano ) 45/M Mesh herniorrhaphy for Rt. Inguinoscrotal hernia
52/M thoracotomy + diverticulectomy and repair was done for Esophageal diverticula (rt middle 3 rd )
33/M Left Posteriolateral Thoracotomy + Wedge resection+ foreign body removal was done for Hemoptysis wndary foreign body with cavity