clinical meet - kamineni institute of medical …...2017/12/21 · intra operative bp - fell down...
TRANSCRIPT
CLINICAL MEET 21ST DECEMBER
Department of Medicine Chaired by
Dr. Rakesh Biswas Professor of General medicine
Dr. Sarat
Marriage (1993)
Divorce (1994)
Worked at HYD (1997-2007)
Schizophrenia diagnosed (2009)
Menopause (2013)
Diabetes (2014)
Abdominal distension (2017)
EVENTS BEFORE HOSPITALIZATION
Birth 1968
25Y
26Y
28 to 38Y
41Y
45Y
46Y
50Y
EVEN
TS
O
F
LIF
E
AGE AND YEARS Dr. Azra
Dr. Spandana
Dr. Spandana
Dr. Spandana
Dr. Spandana
Risk of malignancy indices(RMI) in preoperative evaluation of adnexal
masses
Dr. Sahithi
Dr. Sahithi
GENERAL PHYSICIAN CALL FOR HYPOTENSION ON DAY 4 OF ADMISSION
DAY 1 ADMISSION BP – 90/60 mmHg
DAY 4 ADMISSION BP- 70/50mmHg. Complaints of diarrhea
Signs of dehydration present ? HYPOVOLEMIA
TREATMENT: INTRAVENOUS FLUIDS GIVEN
Dr. Siphora
• PRE OPERATIVE BP- 90/60mmHg
• INTRA OPERATIVE BP -fell down to 60/40mm Hg
• Inotropes- nor adrenaline and central line was secured and 1 unit of whole blood was transfused
• POSTOPERATIVE DAY - 1 BP -120/70 mmHg on inotropes
• Inotropes was weaned off on pod-2
• CVP not mentioned
Dr. Siphora
GENERAL PHYSICIAN CALL FOR HYPOTENSION WITH BP 80/50
mmHg POD 3
• CENTRAL VENOUS PRESSURE WAS 4CM OF WATER
• TREATED AS HYPOVOLEMIA:
INTRAVENOUS FLUIDS GIVEN WITH CVP MONITORING
• PATIENT DISCHARGED WITH BP -100/60
mmHg
Dr. Siphora
PATIENT SECOND VISIT AFTER 2 MONTHS FOR TOTAL HYSTERECTOMY WITH SALPINGO-
OOPHORECTOMY TO SURGERY DEPARTMENT
• C/O Weight loss and loss of appetite • With BP-70/50mmHg and was put on central
line. Fluids and inotropes were started
Dr. Siphora
GENERAL PHYSICIAN CALL FOR HYPOTENSION DAY 2
• Inotropes were weaned off • CVP -3cm of water and IVC diameter 1.3cm • Continuous CVP monitoring and IV FLUIDS
accordingly given. • Patient was taken up for surgery with BP – 90/60
mmHg
Dr. Siphora
• INTRA OPERATIVE BP -90/60mm Hg was maintained with IV fluids.
• POST OPERATIVE BP – 90/60 mmHg
• PATIENT DISCHARGED BP – 100/60 mmHg
Dr. Siphora
Dr. Babji
Dr. Babji
Dr. Shweta
Dr. Shweta
5453/17
Dr. Shweta
How does body react to stress? • Behavioural sensitization to
stress.
• Biological mechanisms : 1.HPA axis dysregulation 2.Dopamine dysregulation
Dr. Afeen
MANAGEMENT OF OVARIAN TUMOR
STAGE 1 A [CLEAR CELL CA OF OVARY] TAH + BSO NO NEED OF CHEMOTHERAPY MONITORING WITH CA125 VALUES
Dr. Sahithi
