Thursday, February 6, 2025

75F With Sudden Headache and Altered Sensorium Telangan PaJR

 


05-02-2025

Ward bed 1:

75F with Sudden headache and altered sensorium admitted same day.



Presented with sudden onset headache followed  altered sensorium along weakness of all 4 limbs.

History of pulmonary tuberculosis 3 yrs back and used antitubercular therapy for 6 months 

Apparently normal doing all her household chores before this episode

No recent weight loss .
No fever

On examination:

Hypertonia of all 4 limbs 
Power could not be elicited.
Asymmetrical deep tendon reflexes with plantars mute.

Outside mri brain down showed acute infarcts bilateral fronto parietal region left centrum semi ovale corona radiation and left occipital lobe

Csf analysis done -
100cells neutrophils 80% lymphocytes 10% 
Monocytes 10% RBC -nil 
Appearance - cloudy

Biochem - sugar 24mg/dl
Protein -111mg/dl
Chloride -110mmol/l

Day 1 She was started on:
inj.ceftriaxone 2gm bd
Inj.ayclovir 400mg 5 times day
Inj.dexamethasone 6mg iv qid i




Paper based notes

06-02-2025


PPM 1 - Ward bed 1 today's update:

And a ridiculously simple photo quiz for the UGs interns here

Why that colour of her urine today?

PPM 3 - Hematuria.

PPM 1 - Check what medication we mentioned giving her yesterday. What does that medication do to the colour of the urine.


PPM 1 - 👆Check out which medication mentioned here can do that to the urine.

PPM 3 - Rifampicin is the one that can cause a change in urine color.
Rifampicin used to treat tuberculosis and can turn the urine a reddish-orange color.

PPM 1 - 👏









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