A 40 year old female with giddiness

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 A 40 year old female who is housewife came to the casuality on 22/2/2022 (night) with

CHIEF COMPLAINTS:-

Chief complaints of GIDDINESS since yesterday morning.(22/2/2022)

HISTORY OF PRESENTING ILLNESS:- 

Patient was apparently asymptomatic 14 years ago then she felt heaviness on the right side while sleeping for which she went to a hospital and was diagnosed with gall stones( details unknown)  for which she underwent surgery and got relieved with the symptoms.

3 years ago she had a history of fall of bricks on her while working and got injured. She came to our hospital where she was done with all the test and found normal. She was sent home.

After 1 year she had  right flank pain ? which was non radiating intermittent and pricking pain  and no aggravating and relieving factors.
She was diagnosed with renal failure on one side and some operation was done (?)
And every 3 months she will follow up . 
In between she will complete of intermittent pain which relieved on water intake.

Since yesterday morning she is complaining of sudden onset GIDDINESS (3 episodes till evening  which relieved after sometime it got relieved itself)  in the first episode she lost consciousness and got up after 10 mins and generalized weakness.
No history of projectile vomiting, fever,nausea,nystagmus,Dysdiadochokinesia,
Headache,no abnormal or loss of sensation.

PAST HISTORY:-

No similiar complaints in the past.
No history of  diabetes, hypertension,TB, Leprosy,asthma. 

FAMILY HISTORY:-

No significant family history

PERSONAL HISTORY:-

Diet :- mixed
Appetite:- normal
Bowel and bladder :- regular
Sleep :- adequate
Addictions:- nil

DRUG and ALLERGY HISTORY:-

No history of allergies for any kind of drugs.

GENERAL EXAMINATION:-

Patient is conscious, coherent and co operative and well oriented towards time , place and person.
Well built and well nourished.

VITALS :- 

Temperature :- afebrile
Bp:- 130/90 mm Hg
RR:- 17 cpm
Pulse rate :- 91 bpm
SpO2 :- 98
GRBS :- 148 mg/dl

Pallor :- absent 


Icterus :- absent
Clubbing:- absent
Cyanosis :- absent
Lymphadenopathy:- absent
Oedema :- absent





SYSTEMIC EXAMINATION:-

CVS :- S1,S2 heard ,no murmers
RESPIRATORY SYSTEM:- bilateral air entry present.
GIT :- no organomegaly

CNS :- 

No meningeal signs



PUPILS - equal

Plantars - B/l Flexion 

Power -. Rt Lt

 Upper limb - 5/5. 5/5

 Lower limb- (5/5)

Tone --

 Upper limb- normal normal

 Lower limb- increased increased.
Reflexes:- Right Left

  Biceps- 

  Triceps- 

  Wrist - 

  Knee - present.preseny

  Ankle - present.present

ENT EXAMINATION:-







OPHTHALMOLOGY examination:-

(Because of blurring vision).



INVESTIGATIONS:-

Hb :- 11.9
TLC :- 6900
Platelets:- 2.68 lakhs

Creatinine:- 0.9
Na :- 142
K :- 4.1
Cl :- 105

LIVER FUNCTION TESTS :- NORMAL

SEROLOGY:- NEGATIVE


ECG :-






MRI :-








PROVISIONAL DIAGNOSIS:-

Benign paroxysmal positional vertigo (BPPV)




DISCUSSION:-









  





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