Sai Manasa

  26 year old woman with complaints of altered sensorium somce 1 day,headache since 8 days,fever and vomitings since 4 days https://harikachindam7.blogspot.com/2020/12/26-year-old-female-with-complaints-of.html a). What is the problem representation of this patient and what is the anatomical localization for her current problem based on the clinical findings? ans) presented to casualty in a state of altered sensorium & irrelevant talk History of B/L hand small joint pains 6 yrs back Multiple joint pains 3 yrs back and diagnosed as SLE  and using treatment which she stopped 10 days ago. C/o headache since 1 month which increased in last 10 - 15 days associated with vomitings since 1 week and fever, neck pain , generalized weakness since 4 days and altered sensorium with irrelevant talk since 1 day. Anatomical localization: Headache,neckpain, fever: tubercular meningitis Acute infarct in thalamus Hyponatremia -kidney b) What is the etiology of the current problem and how would you as

 This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.  Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome.  Case presentation: A 63 year old female who is a retired judicial superintendent came to casualty on 5/1/2021 at 6pm with  ℅ Sob , abdominal tightness , burning micturition since  1 month  Vomitings,Right upper quadrant pain,  since  3 days Patient was apparently asymptomatic 1month back then she developed  abdominal tightness , sob intially grade 3 and now progressed to grade 4 And burning micturition not associated with increased frequency and hesitancy Since 3 days