CPS JAN-2022 QUESTION 2

CASE-1 MULTIPLE MYELOMA

PROBLEM

Solution

Anemia

1 unit of PRBC transfusion

Oedema

INJ. Lasix  20 mg IV/BD

Bacterial Infection ( Gram +ve cocci and gram +ve bacilli were found in the sputum sample)

INJ. Augmentin 0.625 gm/I.V./BD

TAB. Azithromycin 500 mg PO/OD

 

CASE-2 NEUROBEHCET'S DISEASE

PROBLEM

Solution

Hypothyroidism

Thyronorm

ECOSPIRIN

Behcet's(Auto-immune disease)

Methylprednisolone

 

CASE-3 IATROGENIC CUSHINGS SYNDROME

PROBLEM

Solution

Tinea Corporis

Itraconazole

Lulifin

Amlorfine

Fucidic acid cream

Saline compress

Atarax

Hyperpigmented striae

Tretin

CUSHINGS syndrome

Hisone

Hypertension

Telma followed by Telma AM

Cellulitis

Augmentin

 

CASE-4 OSA

PROBLEM

Solution

Hypertension

Olmesartan , Amlodipine

OSA

· CPAP

· Mandibular assist Device

 

 

CASE-5 NEURODEGENERATIVE DISORDER

Patient Problem

Solution

Deviation of Mouth to Right side (3 years ago)

Tab. ECOSPIRIN 75mg

ATORVA 40mg

*6 months

 

Anxiety, Agitation , Sleeplessness

TAB. LORAZEPAM (only if the PT is sleepless)

Dementia due to Alzheimer's Disease

DONEPEZIL

Vitamin supplementation

Optineuron

 

 

 

 

 

 

 

 

CASE-6 MYXEDEMA COMA

Patient Problem

Solution

Electrolyte Imbalance

IV N.S.

Sup. POTCHLOR

Vitamin Supplementation

Optineuron

Maintaining Mean Arteriolar Pressure (MAP)

INJ. NA 2amp in 46ml N.S.

1st Degree Heart Block

INJ. Dobutamine

Hypothyroidism causing the MYXEDEMA

Tab. Levothyroxine

Hydrocortisone

To treat the falling SpO2 caused by airway constriction

Budecort and Duolin *6 hourly

Constipation

Cremaffin

 

CASE-7 METABOLIC ACIDOSIS

PROBLEM

Solution

METABOLIC ACIDOSIS

oral or intravenous sodium bicarbonate to raise blood pH.

medications to dilate your airways.

continuous positive airway pressure (CPAP) device to facilitate breathing.

sodium citrate to treat kidney failure.

insulin and intravenous fluids to treat ketoacidosis.

 

 

CASE-8 CHOREA

PROBLEM

Solution

Chorea

Tetrabenazine

Pharyngitis

 

Eczema

Levocetrizine

Momate F cream

Folliculitis

Mupirocin Gel

 

 

 

 

 

 

 

 

Case-9:- Weil's Disease

 

Patient Problem

Solution

Low platelet count (14,000)

Single Donor Platelet (SDP) transfusion.            => Platelet count raised to 35,000.

Later 2units of FFP was also transfused.

Maintaining SpO2 >95%

Oxygen Supplementation

Correction of Electrolyte Imbalance

I.V. Fluids

Treatment of Leptospirosis

INJ. Ceftriaxone

INJ. Doxy 100 mg

Respiratory Failure (on 4/11/2022)

 Patient Was Intubated

Patient ET tube was blocked due to Blood Clot

Did Mucomist, Ambu & suction and still the saturation didn't improve .

So the Tube was removed and a replaced by a new tube.

During Removal Patient had Bradycardia, Hypoxia and Absence of central and peripheral pulses. 3 cycles of C.P.R was done and the patient REVIVED.

Patient Experienced Hypoxia on High flow oxygen

Patient was kept on CPAP PC overnight

Ventilator Associated Pneumonia

Patient was given Inj. Meropenam ....mg alongwith the Inj. Ceftriaxone and Doxy (for Leptospirosis)

Patient conditions didn't improve and he had spikes of fever in the night. MODS secondary to VAP?.. So Medication were changed :-.                                                                INJ. Colistin    Inj. Doxy.     INJ. Meropenam.

When patient condition still worsened and his Oxygen saturation further reduced. MODS DUE TO VAP AND LEPTOSPIROSIS HE WAS GIVEN:-.

I.V. FLUIDS

INJ. Colistin.    INJ. Amikacin.   INJ.Doxy.      INJ. Meropenam    continuous CPAP MODE

All vitals were falling.. No Central or Peripheral pulse . BP couldn't be recorded

Immediately CPR was initiated according to ACLS guidelines.

But Patient couldn't be revived.

Time of Death 11:30 AM 11/11/2021

 

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