Dr.Keerthi Madireddy

66 YEAR OLD FEMALE CAME WITH -C/O ABDOMINAL DISTENTION SINCE TODAY MORNING(8/6/23). -C/O BURNING TYPE OF PAIN IN UPPER ABDOMEN SINCE 2 DAYS. HOPI: PATIENT WAS APPARENTLY ASYMPTOMATIC 2 DAYS BACK AND THEN DEVELOPED BURNING TYPE OF PAIN IN UPPER ABDOMEN. NO AGGRAVATING AND RELIEVING FACTORS, PAIN NOT RADIATING TO ANY OTHER QUARDRANT. NO H/O FEVER, CONSTIPATION, VOMITING, BURNING MICTURITION. NO H/O TRAUMA. H/O DECREASED APPETITE SINCE 20 DAYS(SINCE USAGE OF ATT). PAST HISTORY: H/O HYSTERECTOMY DONE IN 2001. N/K/C/O DM, HTN, CVA, CAD, EPILEPSY. H/O ASTHMA SINCE 35 YEARS. H/O TB, DIAGNOSED LAST MONTH AND STARTED ATT. PATIENT HAD C/O PAIN IN RUA 20 DAYS BACK AND GOT ADMITTED UNDER GS-VI AND USG WAS DONE SHOWING CHOLELITHIASIS. HRCT CHEST- MULTIPLE CENTILOBULAR NODULES IN BOTH LUNGS. ON EXAMINATION: PALLOR(+) NO SIGNS OF CLUBBING, CYANOSIS, ICTERUS, EDEMA TEMP-AFEBRILE, BP-120/80 MMHG, PR-86BPM, RR-32CPM,SPO2-99% @2L 02,GRBS-136MG% PER ABDOMEN INSPECTION: -ABDOMEN IS DISTEN

 19 FEMALE STUDENT BY OCCUPATION  CAME TO GENERAL SURGERY OPD WITH COMPLAINTS OF PAIN IN LOWER ABDOMEN SINCE 3MONTHS  HOPI: PATIENT WAS APPARANTELY ASYMPTOMATIC 3MONTHS BACK THEN SHE NOTICED PAIN IN UPPER ABDOMEN,SQUEEZING TYPE OF PAIN,INTERMITTENT AND RELIEVED ON DEFECATION AND NO AGGRAVATING FACTORS. PAI IS CONTINUOUS SINCE 10DAYS AND PAIN RELIEVED ON DEFECATION AT MORNING. H/O FEVER ASSOCIATED WITH CHILLS AND RIGOR AND MORE AT EVENING AND RELIEVED AFTER MEDICATION H/O CONSTIPATION SINCE 3MONTHS H/O VOMITINGS AND LOOSE MOTIONS 1MONTH BACK H/O OLIGOMENORRHEA SINCE 6MONTHS H/O WEIGHT LOSS 10KG OVER 6MONTHS NO H/O BURNING MICTURITION NO H/O NAUSEA NO H/O LOSS OF APPETITE  N/K/C/O HTN,DM,ASTHMA,CVA,CAD  NO PAST SURGICAL HISTORY FAMILY H/O FATHER WAS DIAGNOSED WITH TB IN 1995 AND 2007 AND TOOK ANTI TUBERCULOSIS TREATMENT  ON EXAMINATION  PT IS C/C/C BP-90/60 MMHG PR-80BPM RR-17CPM TEMP-AFEBRILE SPO2-99% ON ROOM AIR L/E ON INSPECTIONABDOMEN IS SCAPHOID UMBILICUS-CENTRAL AND INVERTED ALL Q