NH/O Previous medical illness a 32 yrs female admitted with c/o diffculty in breathing,palpitation,cough,swelling on face O/E chest b/l crepts BP 210/120mm/hg P/R 160/min spo2 80at RA pls suggest treatment and diagnose@



I think this PT is acute IHD...and bronchial asthma .done 2DECO...LFT.RFT...test

U should have sent the ECG also .

Sorry, I couldn't see the ECG.

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Hypertensive emergency with end organ damage..lower BP slowly by NTG infusion give o2 diuretics .Antibiotics as per renal criteria..admit in icu.

Dibetic nephropathy with stage III Hypertension,should be treated with Nifedepin 20mg SR tablet,renal antioxident.calcium and phosphate with proper ratio(after blood biochemistry analysis),Erythropoietin,vitamin D3 etc.

In antibiotic..neb..ntg infusion...and inj Lasix..diag may b bronchial asthma and IHD..require routine inv.

Unstable angina with ACS.ECG shows inferior wall ischaemia with old anteroseptal MI.Pt.should be given 300mg clopidogrel,300mg aspirin stat along with Fondaparin or enoxaparin.Trop I and CPK MB should be estimated along with repeat ecg.blood sugar and creatinine should be checked and managed accordingly with insulin.

Complete diagnosis should be HT with diabetes with CRF with LVF.ECG shows LVH with strain.Again x ray chest shows cardiomegaly.For man

For immediate management should control diabetes,give diuretics to control HT and LVF.Can add some antibiotics cover as TLC slightly raised.Swelling of face is due to CRF and anaemia associated with lvf.

Hypertensive emergency with lvf and renal dysfunction.go for renal doppler and echo

Lower bp with ntg infusion... Usg abdomen to rule out kidney dz.. Iv antibiotics n supportive

Use diuretics to lower BP SupportIve mangement till pt stabilises

Young female first thought is acute on chronic renal failure Urine fr proteinuria to r o nephrosis Check pressure in both legs 2 echo may show diastolic dysfunction Lower pressure slowly Abg is required Ofcourse rest of management depend upon further tests usg Ntg Lasix Even check fr serum cortisol

Agree with Dr sanjay

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