Unit 3 admission




 A 75 year old male patient came to casuality in unresponsive state since 1 hour.Patient was having fever since 10 days .


Complaints-


HOPI-patient was apparently -


 - asymptomatic 10days back then he had insidious onset of fever 


- low grade intermittent ,releived with medication,


- not associated with any chills and Rigors.


Yesterday morning he woke up,done his routine works and was normal till evening ,went to sleep and they tried to wake him up,as the patient was unresponsive they brought him to our hospital.


4 months back patient wide was demised ,from then he was not interacting actively with his family members and having excessive sleep 


Patient attendees are saying that patient had h/o wt loss 


Patient had h/o left sided scrotal swelling since 6 years


  


Past illness- 


No h/o diabetes ,HTN,Asthama ,TB and epilepsy 




Present history-


Appetite -decreased since two months 


Sleep -excess


Bowel and bladder movements -normal nd regular 


Addictions -none 




On Examination




E1,V1,M1


BP-140 systolic 


PR-42/min,regularly,irregular 


RR-BLAE present




CVS :


 S1S2 HEARD 


no thrills no murmurs




Per abdomen:


Non distended


Diffuse tenderness absent 


Guarding and rigidity absent




CNS-


                  Right         Left 


Tone  UL.  Hyper        Hypo 


           LL.  Hypo         Hypo 




Power  UL  -                 -


             LL  -                 -




Reflexes-


            B-   ++       ++


            T-   ++       ++


            S     ++      ++


            K-    +         -


            A-    -          -


            P- extensor extensor




Diagnosis- ? 


 Uremic encephalopathy with AKI on CKD













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