39M GAD NUD Ethanolism WB PaJR

 10-01-2025

This is an Online E Log Book to discuss our patient's de-identified health data shared after taking his signed informed consent. Here we discuss our patient's problems through series of inputs from available global online community experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.

PPM 3 - 

PPM 1 - 👍

11-01-2025

PPM 3 - LFT

PPM 1 - When was his last drink?

PPM 4 - 5 days ago sir.

Hemogram.

PPM 3 - Serum Creatinine.

PPM 1 - Mild rise in MCV

Early hint of vitamin B12 definitely

But never do vitamin B12 levels. That's not a useful test.

PPM 1 - Explains his LFT

And mild withdrawal signs such as tremors

Share the psy notes

Have they started lorazepam or was he already on it before getting admitted yesterday?

PPM 5 - 

PPM 3 - Stool for occult blood.

PPM 1 - If it's negative it's useful in ruling out a bleed

In this case positivity can be non specific

If we are worried about upper GI bleed the best and quickest way to resolve is to insert a ryles tube and give a mild 100 ml lavage

Also check the BP supine and standing after three minutes to detect significant postural drop that would accompany any significant upper GI bleed.

PPM 4 - Okay sir.

PPM 1 -Lavage him only if when the postural fall is significant.

PPM 3 - No significant postural BP drop sir 

Supine -90/60mmhg

Standing- 90/60mmhg

PPM 1 - Thanks.