A patient with hypoglycemic attack
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A male patient of age 47 year old came to OPD with the complaint of loin pain radiating to groin since 3 days and history of hypoglycemic attacks
HOPI :- patient was apparently asymptomatic 10-15 years back then he developed pain in the abdomen for which he was told some swelling in the abdomen then laparotomy was done and swelling was excised ,3years back he developed pain in the abdomen and vomiting and diagnosed with cholilithiasis and cholecystectomy was done
Now since 8days patient has right loin pain, sudden colicky type not nausea and vomiting then he was told in the hospital he has right enteric stones
4 days back patient visited other hospital with old reports for second opinion ,then incidentally had a fbs-89 , plbs -240, then he was Started on OHA's for 3days following which he had stoped OHA's as he developed hypoglycemia
HOPI:-
N/K/C/O HTN and DM
Personal history :-
married
Appetite normal
Mixed diet
Bowel movements Regular
Normal micturition
No known allergies
Habits :- occasionally alcohol that to twice a month
FAMILY HISTORY :-
no known member's of the family has similar disease
General examination :-
Patient is c/c/c
No pallar
no icterus
No cyanosis
No clubbing
No lymphadenopathy
No oedema
VITALS :-
Temp:- 98.7
Pulse rate :- 82/min
Res. Rate :- 18 / min
Bp :- 110/70 mm/hg
Spo2 :- 98%
SYSTEMIC EXAMINATION :-
CVS - S1, S2 heard and no murmurs
RS - BAE + , No added sounds
PROVISIONAL DIAGNOSIS :-
Right proximal ureteric calculi ,mild right hydronephrosis
