26year old male with chronic diarrhoea

DR.NAVYA(INTERN)

DR.CHETANA(INTERN)

DR.ABDUL RAHEEM (INTERN)

DR.ASHFAQ(INTERN)

DR.SRAVYA(INTERN)

DR.GNANADA(INTERN)

DR.CHARAN(PG1)

DR.VAMSI(PG1)

DR.SUSMITHA(PG2)

DR.ADITHYA (PG3)

DR.PRANEETH(PG3) 

DR.PRAVEEN NAIK (ASS.PROF)

DR.RAKESH BISWAS(HOD)

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Here is a case i have seen:

61 year old male with Chief complaints of  grade 2 SOB and cough with expectoration since one week. 

HOPI:patient was apparently asymptomatic week back then he had fever, cold, cough, shortness of breath for which taken to the local hospital in motkur and symptomatic treatment was given. history of fever which was  intermittent low-grade decreased with medication present for 5 days.cough with expectoration- white in  colour, minimal amount, non foul smelling, non blood stained.  no history of chest pain, palpitations, orthopnea, PND.  No h/o coronary artery disease, tuberculosis,thyroid disorders.

addictions like toddy since 25 years of age one bottle per day and alcohol since 30 years of age 90ml per day. Beedi 2 packets per day since 50 years of age.

O/E :

 patient is conscious, coherent, cooperative.

Grade -4  Clubbing  present.

no signs of pallor, icterus,cyanosis, lymphadenopathy, pedal edema.

Vitals :

temperature- 98.4F 

pulse rate: 60 Bpm regular 

respiratory rate :16 cpm

BP :110/ 90 mm of Hg

Head to toe Examination: temporal wasting +

Oral cavity  tobacco stains on tooth. Leukoplakia  on soft palate.

 Mallam Patti grade -1. Locomotor brachi - present.

Respiratory examination

Inspection :

flat alar chest, pectus excavatum.reduced chest movements on right side.

Palpation-  trachea  appears to be cental. apex beat not palpable.

chest expansion - 1.25 cm.reduced chest expansions in infraclavicular, supraclavicular, mammary, infra mammary,  supra scapular on right side.

Percussion - dull note in right suprascapular area. 

Auscultation-

Bilateral air entry present.

Mid inspiratory coarse crepitus present all over the areas of the lung ( more on left).