Medicine case

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.  A 16 yr old girl  who is a k/c/o DM type 1 was brought by her mother with c/0 vomitings and pain abdomen since 4 days She was apparently alright 10 years back , one day she suddenly had fever with chills and burning sensation all over the body for which got diagnosed as DM-type 1 on routine investigations She is on regular medication since then on INSULIN(ISOPHANE-10u+REGULAR INSULIN 10u) After 6yrs of regular medication she missed her doses on and off for which she go

1)Anatomical diagnosis -? Glomerulosclerosis                                                                        Etiological diagnosis -  ?? Nephrotic syndrome secondary to the diabetic nephropathy or CKD.      2)Reasons for I) Azotemia : impaired renal excretion of urea and creatinine secondary to CKD.  II) Anemia : decreased erythropoietin.  III) Hypoalbunemia: capillary basement membrane and podocytes damage.  IV)  acidosis: acidification of urine is lost.                                       3) Rationale : syp potchlor was given because of the hypokalemia.. Inj. NaHCO3 was given because of metabolic acidosis ..Insulin and antihypertensives are given because known case of DM and HTN. Orofer XT was given because of anemia.. Inj. Lasix was given to decrease her volume overload. Spironolactone was given it was a potassium sparing diuretic.Calcium was given to the patient  because of hypocalcemia secondary to CKD. Indications of NaHCO3:metabolic acidosis in cardiac arrest, Tricyclic

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. Here is a case i have seen :  A 41yr old man  who is a farmer came with complaints of pain abdomen and vomitings since one day Patient was apparently alright 2 days back later he had pain abdomen following an acute binge of alcohol(750ml of local liquor) in epigastric region, colicky type,non progressive, non radiating,Which got relieved on taking food He had vomitings-2 episodes, non bilious,non projectile,contents being food particles No H/o fever, loose stools, melen