14 yr old male with involuntary movements and vomitings

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A 14 year male patient presented to Opd with cheifcomplaints of involuntary movements and vomitings since 1 day.

History of present illnesses:

-Patient was asymptomatic 20 days back and then he noticed facial puffiness and pedal edema for which they consulted local health care centre.

-After few days he developed fever vomitings and involuntary movements.

-He also noticed coca coloured urine.

History of past illness:

No history of diabetes, hypertension, epilepsy,Asthma and TB.

Personal history:

Diet:mixed

Appetite:Normal

Sleep: adequate

Bowel and bladder movements: regular

No addictions

No history of allergy to the known drugs.

Family history: 

No history of similar complaints in the family.

Treatment history:

He was  given symptomatic treatment for fever facial puffiness and pedal edema.

General examination:

Patient was concious coherent and coperative well oriented to time place and person.

Built:well built

Nourishment: well nourished..

-No pallor

-No clubbing

-No cyanosis

-No icterus

-No generalized lymphedenopathy

-No pedal edema.

Vitals :

Temperature : Afebrile

Pulse rate: 82 beats per min

Respiratory rate : 17 cycles per min

Bp :110/70 mm of Hg..

SYSTEMIC EXAMINATION 

CARDIOVASCULAR SYSTEM

Inspection : 

Chest wall is bilaterally symmetrical

No Precordial bulge

No visible pulsations, engorged veins,scars, sinuses

Palpation :

JVP - normal

Apex beat : felt in the left 5th intercostal space

In midclavicular line 

Auscultation :

S1 ,S2 Heard

RESPIRATORY SYSTEM

Bilateral airway +

Position of trachea- central

Normal vesicular breath sounds - heard

No added sounds

PER ABDOMEN

Abdomen is soft and non tender 

Bowel sounds heard

CENTRAL NERVOUS SYSTEM

Patient is conscious 

Reflexes are normal 

Speech is normal.

Investigations -

HEMOGRAM

Chest x-ray PA VIEW

CUE 

CT BRAIN 


RBC IN URINE MICROSCOPY 



Treatment:
Inj Zofer 4mg IV
Tab PCM 650 mg
Inj optineuron 10 mp in 100 ml NS IV
Tab sodium valproate 500mg OD 
Inj pantop 40mg IV
Fluid restriction <1.5L per day
Salt restriction <4gm per day

Diagnosis: Acute glomerulonephritis post streptococcal


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