Female with recurrent vomiting.
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A 34-year-old female patient Present it to casualty with complaints of vomiting since three days associated with giddiness And generalised weakness
BP was 60 MMHG systolic on presentation with 1L IV bolus BP increase to 110/60 MMHG
34 yrs old female ,daily labourer by occupation, resident of Choutuppal got married at 15 years of age has three children
Patient was apparently alright six months ago then she had complains of recurrent episodes of vomiting 2-3 episodes per day containing food particles, non-bilious, non-blood stained, non-projectile
Not associated with pain abdomen, no loose stools, no fever, cough, SOB vomitings - associated with nausea and loss of appetite
Patient complains of vomiting immediately after food intake or even after intake of water within half an hour vomits everything
Complains of weight loss
History of recurrent visits to local hospital and RMP for vomitings and got symptomatic relief
No history of headache blurring of vision
No history of chest pain tightness
No history of difficulty in swallowing weakness tingling
No history of past illness
History of Surgery Tubectomy+
And 2 C-sections +
Personal history
married
Occupation-daily wage labourer
Constipation (once in 2 to 3 days)
No known allergies
no addictions
No significant family history
Menstrual history
Regular cycles 3/30
no history of Menorrhagia, Dysmenorrhea
Examination
General examination
patient is C/C/C
Pallor present
No Icterus, Clubbing, Pedal Oedema
Temperature 98.2° F
PR 150 BPM
RR 25 CPM
BP 60 MMHG
SPO2 98@ RA
CVS- S1,S2 +
RS-NVBS +
p/A– soft non-tender
CNS- no FND
Provisional diagnosis:
Acute hypertension 2° to dehydration/chronic vomitings
Chronic vomitings under evaluation
Plan of Treatment:
IVF 2 NS/IV/stat
IVF -NS, RL, DNS @100ML/hour
Inj. OPTINEURON 1amp in 100ML NS/IV/OD
Inj. PAN 40mg/ IV/ OD
Inj. ZOFER 4mg/ IV/ TID
Monitor vitals 4th hourly.
