A 40 YEAR OLD WITH PNEUMONIA

This is an E log book to discuss our patients de identified health data shared after guardians informed consent.

Here we discuss our individual patient problems through series of inputs from available global online community of experts with an aim to solve this patients clinical problems with collective current best evidence based inputs.

This E-book also reflects my patients centered online learning portfolio and your valuable comments in comment box are most welcome.

I have been given this case to solve in an attempt to understand the topic of "patient clinical data analysis" to develop my competency and to comprehend clinical data including history, clinical finding investigations and come up with a diagnosis and treatment plan.



CHIEF COMPLAINTS

- Fever since 3 days 
- cough (dry cough) since 3days 
- shortness of breath grade 4 since 3 hours 


HISTORY OF PRESENTING ILLNESS

Patient was apparently asymptomatic  3 days ago then he had fever associated with chills and rigors  then he developed dry cough, and then developed SOB Grade 4 since 3 hours.
No h/o cold, nausea, vomiting, loose stools.



PAST HISTORY
Not a known case of Diabetes, Hypertension, Tb, Asthma, Epilepsy, CAD, Chemotherapy

FAMILY HISTORY
Not significant
PERSONAL HISTORY
Diet - mixed
Appetite - Decreased 
Bowel and bladder - adequate
Allergies -no
Addiction -  intake of alcohol 
90ml daily 

GENERAL EXAMINATION

The patient is conscious, coherent, cooperative, well oriented to time, place and person
Thin built and malnourished 
The patient was examined after taking consent in a well lit room. 

Vitals
Temperature : Afebrile 
Pulse: 90
BP:120/70 mm/ hg
RR :26
SPO2 : 92%
GRBS:127 MG%


Pallor : ABSENT 
Icterus : ABSENT 
Clubbing :ABSENT
Cyanosis :absent
Lymphadenopathy: absent
Pedal edema: absent

SYSTEMIC EXAMINATION
CVS
Apex beat 6 th intercoastal space
No thrills
S1 S2 heard
No murmurs

ABDOMEN EXAMINATION


RESPIRATORY SYSTEM

dyspnoea wheeze+
Central trachea 
Bilateral air entry +
Bilateral basal crepts +


INVESTIGATIONS



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