Download Free Medical Chronic diarrhea in HIV Family Case PowerPoint Presentation

Chronic diarrhea in HIV Family Case PowerPoint Presentation

DOWNLOAD MEDICAL POWERPOINT PRESENTATION

About This Presentation

Description : Family Case

Tags : Family case

Published on : Feb 23, 2020 | Views : 2375 | Downloads : 4

Shareable Url :

Embed Code :

Comment

Transcript

Slide 1-

REPUBLIC OF THE PHILIPPINES DEPARTMENT OF HEALTH DR. JOSE R. REYES MEMORIAL MEDICAL CENTER Medical Grand Rounds Moderator: Dr. Higinio Mappala Reactor: Dr. Mario Panaligan Dr. Darshan Kumar Gurung Dr. Madelle De Leon Dr. Nawli Manandhar Double Trouble: Chronic diarrhea in HIV
Slide 2-

Objectives: To present a case of chronic diarrhea in HIV patient. To discuss the approach to diagnosis and management of HIV patients with chronic diarrhea. To present the epidemiology of HIV and AIDS in the Philippines. To present the fast tract approach to target sustainable developmental goal in HIV/ AIDS patients in the Philippines.
Slide 3-

General data L.G. 26-year old Male Single Bulacan City
Slide 4-

Chief complaint loose watery stools
Slide 5-

History of present illness
Slide 6-

History of present illness
Slide 7-

History of present illness ADMISSION
Slide 8-

Review of systems
Slide 9-

Past Medical History Non-hypertensive Non- diabetic No history of PTB Non-asthmatic No history of blood transfusions, tattoos No known food and drug allergies
Slide 10-

Family history (-) hypertension (-) Diabetes (-) cancer (-) stroke
Slide 11-

Personal social history non-smoker occassional alcoholic beverage drinker denies illicit drug abuse occupation: respiratory technician sexual history: Multiple male partners
Slide 12-

Physical Examination
Slide 13-

Physical examination
Slide 14-

Salient features 26M chronic watery stool, abdominal pain, loss of appetite and fever weight loss 7kg over 1 month Multiple Male sexual partners Febrile Tachycardic at 102bpm Dry lips, Whitish plaque buccal mucosa Flat, soft, hyperactive bowel sounds
Slide 15-

Initial Impression: Chronic diarrhea of undetermined etiology with mild dehydration.
Slide 16-

Courses in the ward
Slide 17-

1st hospital day intermittent fever Loose watery diarrhea Diagnostics: CBC Na, K creatinine fecalysis urinalysis Treatment: Paracetamol 300mg IV q 4 hrs for fever Nystatin 100,000 IU/ml 5ml qid Referred to ID service
Slide 18-

2nd hospital day IDS: Impression: Immunocompromising conditions with multiple opportunistic infections: Oral Candidiasis Chronic diarrhea TB and PCP Hepatitis B infection Piptazo 4.5mg IV q6 TMP-SMX 160/800mg 1 tablet OD Continue Nystatin
Slide 19-

2nd hospital day Additional labs were requested such as Hepatitis profile blood CS mycobacterial blood C/S RPR, VDRL serum CALAS modified acid fast stool PPD
Slide 20-

4th hospital day intermittent fever diarrhea occasional cough INH 300mg/tab 1 tab q24h Azithromycin 500mg/tablet 2 & ½ tablet every Saturdays
Slide 21-

5th hospital day episodes of vomiting hypotensive episodes 70/40 Fluid challenge of 1L
Slide 22-

10th hospital day Sent home with following meds: Levofloxacin 750mg/tab OD for 6days TMP-SMX 160/800MG 2tabs three times a day for 2 weeks then OD Azithromycin 500mg/tab 2and ½ tab q weekly (every Friday) till follow up INH 300mg/tab 1tab q24 for 9 months Multivitamin 1 tab OD Nystatin 100,000 units/ml 5ml TID for till follow up
Slide 23-

Diarrhea passage of abnormally liquid or unformed stools at an increased frequency stool weight >200 g/d
Slide 24-

ppt slide no 24 content not found
Slide 25-

Diarrhea >4 weeks
Slide 26-

Chronic infectious Parasites: G. lamblia, E. histolytica AIDS related: Viral: CMV Bacterial: C. difficile, Mycobacterium avium complex Protozoal: microsporidia (cryptosporidium, isospora belli,enterocytozoon bieneusi)
Slide 27-

Inflammatory conditions Idiopathic inflammatory bowel disease Crohn’s and chronic ulcerative colitis Malignancy lymphoma Adenocarcinoma Radiation enteritis HIV Enteropathy
Slide 28-

Final diagnosis HIV enteropathy Acute hepatitis B infection, infective
Slide 29-

Thank you..
Slide 30-

ppt slide no 30 content not found
Slide 31-

ppt slide no 31 content not found
Slide 32-

ppt slide no 32 content not found
Slide 33-

WAB UTZ 9/21/2016: Hepatomegaly with fatty infiltrates, normal sized GB with reactive GB wall thickening, minimal ascites, bilateral pleural effusion
Slide 34-

Blood c/s : no growth
Slide 35-

Urine R/E: Color: yellow Character: clear Reaction: 6.0 Sp gravity: 1.020 Sugar/protein/bil/ketone/urobilinogen/nitrite- negative RBC: 0-3 WBC: 0-2 Crystals: none found Epithelial cells: few Bacteria: few Cast : none Mucus thread: few
Slide 36-

ppt slide no 36 content not found