THYROIDITIS


28yrs old female farmer  by occupation came to gm OPD with 

c/o  fever since 4 days with  retro-orbital pain

C/o headache ( diffuse pain ) ;

c/o  nausea since 3 days

Bodyaches since 3 days

C/O swellling on the neck 

C/O SOB grade 2 with palpitations

HOPI: patient was apparently asymtommatic 14 days back then she developed fever after taking her COVID VACCINE associated with vomitings for 2 days ( 4-5 episodes/day ) visited RMP took medications and fever subsided

C/o fever with retroorbital pain since 3 days with diffuse head ache type associted with nausea

 Fever highgrade , continuous fever , nocturnal variation present , associted chills and rigors .

Vomitings ( 2 episodes ) on 1st day of fever ( non bilious , non projectile )

No episodes of vomitings next two days ( only nausea feeling )

No cold , cough ,loose stools

C/o hair loss since 3 days

Weight loss since 3 years

No cold /heat intolerance 


Past history :

5 months back she c/o giddiness and she visited RMP  where she was diagnosed of low BP

Married  at the age of 15yrs

2009 - boy ( c section )

2011 - daughter 

2013 - daughter ( had 2 blood transfusions)

2014 - 1 more transfusion due to less hb% and Tubectomy was done

Mentrual history :

age of Menarche 14 yrs 

17yrs : marriage

Cycles : Irregular menstrual cycles since 2 yrs

6/20 ; 3-4 pads/ day

Clots present

Backache present

Stomachache present

Bleeding increased since 2 yrs


Physical Examination 

No signs of icterus cynosis clubbing edema dehydration malnutrition 

Pallor - present

Lymphadenopathy - present ( cervical )

Temp - 98.5 F

PR - 88 bpm

RR - 17 Cpm

Bp - 110/60mmhg

SpO2 - 98% at RA

Grbs - 141 mg/dl


Systemic examination 

Cvs : s1 s2 heard no murmurs

Rs : Nvbs + 

P/a : soft , non tender

Cns : higher mental functions normal

    

20/10/2021 : HB

                     WBC

                      PLT

21/10/2021 : HB

                     WBC

                      PLT

22/10/2021 : HB

                     WBC

                      PLT

23/10/2021 : HB

                     WBC

                      PLT

24/10/2021 : HB

                     WBC

                      PLT

25/10/2021 : HB

                     WBC

                      PLT

26/10/2021 : HB

                     WBC

                      PLT

27/10/2021 : HB

                     WBC

                      PLT

28/10/2021 : HB

                     WBC

                      PLT

29/10/2021 : HB

                     WBC

                      PLT

30/10/2021 : HB

                     WBC

                      PLT























OBG Consultation Notes




23/10/2021
Bp - 110/80 mmhg
Temp - 101 F
Pr - 89 bpm
Grbs - 98 mg/dl
Cvs - s1s2 present no murmurs
Rs - nvbs +
P/a - soft non tender
Cns - NAD
I/O - 4000/1600 ml
Rx : IVF NS,RL @ 50ml/hr
Plenty of oral fluids
T.PCM 500 MG PO/TID
T.OROFER-XT PO/BD
T.ULTRACET PO/QID
T.PAN 40 MG PO/OD
INJ MONOCEF 1GM IV/BD
INJ TAZAR 4.5G IV/TID


24/10/2021
Bp - 110/80 mmhg
Temp - 99 F
Pr - 72 bpm
Grbs - 113 mg/dl
Cvs - s1s2 present no murmurs
Rs - nvbs +
P/a - soft non tender
Cns - NAD
I/O - 4000/1600 ml
Rx : IVF NS,RL @ 50ml/hr
Plenty of oral fluids
T.PCM 500 MG PO/TID
T.ULTRACET PO/QID
T.PAN 40 MG PO/OD
INJ TAZAR 4.5G IV/TID

25/10/2021
Bp - 110/80 mmhg
Temp - 99.6 F
Pr - 86 bpm
Grbs - 109 mg/dl
Cvs - s1s2 present no murmurs
Rs - nvbs +
P/a - soft non tender
Cns - NAD
I/O - 2700/2200 ml
Rx : IVF NS,RL @ 50ml/hr
Plenty of oral fluids
T.PCM 500 MG PO/TID
T.ULTRACET PO/QID
T.PAN 40 MG PO/OD

26/10/2021
Bp - 110/80 mmhg
Temp - 
Pr - 89 bpm
Grbs - 98 mg/dl
Cvs - s1s2 present no murmurs
Rs - nvbs +
P/a - soft non tender
Cns - NAD
I/O - 4000/1600 ml
Rx : IVF NS,RL @ 50ml/hr
Plenty of oral fluids
T.PCM 500 MG PO/TID
T.OROFER-XT PO/BD
T.ULTRACET PO/QID
T.PAN 40 MG PO/OD
INJ MONOCEF 1GM IV/BD
INJ TAZAR 4.5G IV/TID


27/10/2021
Bp - 110/80 mmhg
Temp - 
Pr - 89 bpm
Grbs - 98 mg/dl
Cvs - s1s2 present no murmurs
Rs - nvbs +
P/a - soft non tender
Cns - NAD
I/O - 4000/1600 ml
Rx : IVF NS,RL @ 50ml/hr
Plenty of oral fluids
T.PCM 500 MG PO/TID
T.OROFER-XT PO/BD
T.ULTRACET PO/QID
T.PAN 40 MG PO/OD
INJ MONOCEF 1GM IV/BD
INJ TAZAR 4.5G IV/TID
 
28/10/2021
Bp - 110/80 mmhg
Temp  98.5
Pr - 76 bpm
Grbs - 98 mg/dl
Cvs - s1s2 present no murmurs
Rs - nvbs +
P/a - soft non tender
Cns - NAD
I/O - 4000/1600 ml
Rx : IVF NS,RL @ 75ml/hr
Plenty of oral fluids
INJ.PARACETMOL 100ML/IV/SOS
INJ.PAN 40 MG PO/OD
INJ MONOCEF 1GM IV/BD
INJ ZOFER 4MG IV/SOS
INJ DOXYCYCLIN 100MG/IV/BD
SYP SUCRALFATE 10ML/PO/TID/B\F
 
29/10/2021
Bp - 110/80 mmhg
Temp  98f
Pr - 76 bpm
Grbs - 98 mg/dl
Cvs - s1s2 present no murmurs
Rs - nvbs +
P/a - soft non tender
Cns - NAD
I/O - 4000/1600 ml
Rx : IVF NS,RL @ 75ml/hr
Plenty of oral fluids
INJ.PARACETMOL 100ML/IV/SOS
INJ.PAN 40 MG PO/OD
INJ MONOCEF 1GM IV/BD
INJ ZOFER 4MG IV/SOS
INJ DOXYCYCLIN 100MG/IV/BD
SYP SUCRALFATE 10ML/PO/TID/B\F
 
30/10/2021
Bp - 120/80 mmhg
Temp  97.5ff
Pr - 76 bpm
Grbs - 121 mg/dl
Cvs - s1s2 present no murmurs
Rs - nvbs +
P/a - soft non tender
Cns - NAD
I/O - 4000/1600 ml
Rx : IVF NS,RL @ 75ml/hr
Plenty of oral fluids
INJ.PARACETMOL 100ML/IV/SOS
INJ.PAN 40 MG PO/OD
INJ MONOCEF 1GM IV/BD
INJ ZOFER 4MG IV/SOS
INJ DOXYCYCLIN 100MG/IV/BD
SYP SUCRALFATE 10ML/PO/TID/B\F
 
 
 
 
 
 
 












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