Acute Diarrhea

List of patients for week of:

No.

Patient’s Name

AgeSex

Chief Complaint

Vital Signs

DifferentialDiagnosis

Pertinent Signs & Symptoms

Work up:Lab & Imaging

Medications Note,(comment)

1

Dental1981M

Holes in the surface of a tooth, Pain when, chewing, Sensitivity to hot or cold foods and beverages, Toothache

BP:123/84P: 67T:36,2RR: 16

Periodontal ligament disordersOcclusal traumaTrigeminal neuroma/ neuralgiaPostherpetic neuralgia

Toothache NA Amoxicillin 500 mg – 10Mefenamic acid 250 mg – 10

Recommendations:Visit a dentist soon as, to observe good dental hygiene, daily brushing of teeth, avoiding excessive tea and coffee consumption.

2 Cold 1983M

The patient complaints headaches what starts few hours ago, he described flu-like symptoms since 24 hours including sore troth, nasal stuffinessand

BP:133/86P: 82T:35,3RR: 16

URI/LRIInfluenzaViral diseasePneumonia HIV DiseaseHayfever (allergic rhinitis)SinusitisTonsillitisAcute sinusitis

Sore trothHeadachesDry coughGeneral weakness

N/A Azytromicine 500mg – 3Co-codamol – 10Orofar - 8

Return for review after two daysThe patient clothed is not suitable with the present weather.Recommendations:Wear adequate clots and footwear, drink lots of fluids, fruits, in case of

English Village, Gulan Street, Erbil, Kurdistan Region of Iraqwww.bcm-medical.com

http://emedicine.medscape.com/article/211316-overview

hoarseness slight sore troth accompanied by dry cough and mentioned a mild discomfort (irritation) during miction

fever or if the symptoms will get worst return for review

3

Pirosis1988M

The patient complains pain and a burning like sensation in the gastric region after the consumption of food

BP:123/84P: 67T:36,5RR: 16

Gastric / Duodenal ulcerCholecystitis / CholelitiasisEsophagus, foreign bodyGastric acid aspirationEsophageal free reflux/GERD syndromeBiliary tree disorder

Heartburn NA Eno acid relieving - 1

The patient was instructed hove he should use the medication

4 Allergy 1982M

The patient complains dry skin after shower

BP:143/89P: 73T:36,3RR: 17

Common cold Connective tissue

disorder Gastrointestinal

illness Hormone disorder Infection

Dry skin, Headaches

NA Dermocal cream – 1Panadol 500mg - 10

5 Dry lips S

1976M

Dry Lip BP:123/84P: 70T:36,3RR: 17

N/A Dry lip N/A Hydroderm lip balm - 1

Recommendations:Stay hydrated

6 Otitis 198 The patient BP:137/84 Foreign boy in ear Inflamed N/A Erythromycin The symptoms


http://www.mdguidelines.com/scleroderma

http://www.mdguidelines.com/scleroderma

http://www.mdguidelines.com/cold

Media 7M

complains pain to left ear since 24 hours ago accompanied by mild pain to left side lymph nodes

P: 96T:36,7RR: 17

Middle ear traumaMiddle ear tumorOtitis externaSinusitisExternal Ear infectionBarotraumaMastoiditis

middle ear Pain to left ear, Headaches, diminished hearing, swollen lymph nodes to left side

500 mg – 10Gentadex ear drops10ml – 1Adol 500 - 10

are NOT associated with signs of upper respiratory infection such as a runny or stuffy nose, or a cough. No accumulation of pus the tympanic membrane is blistered and inflamed.

7 Acute diarrhea

1979M

The 33-year old man presented to K2 camp clinic at 7:30 AM complaining abdominal pain and diarrhea and fatigue. He had felt well until 2:00 AM, when he began suffering from crampy abdominal pain in the full lower abdominal quadrant accompanied

BP:121/84P: 77T:36,6RR: 17

GastroenteritisUlcerative colitisAppendicitisIrritable Bowel SyndromUlcerative Colities

Frequent loose, watery stools,

Bloating,Abdominal cramps

Abdominal pain

Abdominal distention

N/A Entero stop – 5Hyoscine – 5ORS – 3

The patient did not drink milk or consume many dairy products except for yogurt, which did not seem to bother her.Recommendations:To drink lots of fluids in the next 24h, if the symptoms will be the same or get worst return for review.


http://www.medicinenet.com/script/main/art.asp?articlekey=1977




http://www.mdguidelines.com/barotitis-media

http://www.mdguidelines.com/sinusitis

http://www.mdguidelines.com/otitis-externa-infective

by abdominal distention. He said that his stools were watery and occurred six stools episode of defecation.

7B

Diarrhea 1976M

The patient presented to K2 camp clinic at 7:00 AM complaining crampy abdominal pain in the full lower abdominal quadrant. He said that his stools were watery and occurred 4 stools episode of defecation.

BP:123/84P: 73T:36,4RR: 15

GastroenteritisUlcerative colitisAppendicitisCarcinoid tumorCongenital Microvillus AtrophyCystic fibrosisGiardiansis Intestinal Deficiensy Intestinal Protozoal Disease Irritable Bowel SyndromMalabsorption SyndromesMeckel DiverticulunkProtein intoleranceShigella InfectionShort Bowel SyndromUlcerative Colitis

Frequent loose, watery stools,

Bloating,Abdominal cramps

Abdominal pain

Abdominal distention

N/A Entero stop – 5Hyoscine – 5ORS – 3Scopinal 20mg/ml – 15ml Syringe – 1Needle - 1

The patient did not drink milk or consume many dairy products except for yogurt, which did not seem to bother her.Recommendations:To drink lots of fluids in the next 24h, if the symptoms will be the same or get worst return for review.

8 Pirosis 1980M

The patient complains pain and a burning like sensation in the gastric region after

BP:120/82P: 62T:36,5RR: 16

Gastric acid aspirationGastric ulcerDuodenal ulcerCholelitiasis\Chronic cholecystitisBiliary tree disorderEsophagus disorders

Heartburn NA Eno acid relieving - 1

The patient was instructed hove he should use the medication


the consumption of food (25 minutes ago).

Alcohol gastritis

9 Tonsillities

1987M

The patient complaints sore troth and difficulty with swallowing. The sore troth start two days before. He feeling of being tired and unwell. In the last 6 hours the headaches gat maximum intensity.

BP:123/84P: 67T:36,2RR: 15

URI/LRIPneumoniaBronchopneumoniaChronic sinusitisAcute sinusitisInfluenza

Headaches, Nasal drainage, FatigueSore trothpain in mouth with swallowingloss of appetitepus on the tonsils

NA Azithromycin 500mg – 3Adol 500mg – 10Multivitamin effervescent – 20Orofar - 8

Avoid cigarette smoke and other irritants. Stay hydratedReturn for review after three days.

10

Delayed onset muscle soreness (DOMS)

1985M

The patient complains swollen feeling sensation in thigh tissues, paresthesia

BP:115/79P: 87T:36,5RR: 15

Muscle or tendon injury,

muscle tenderness

N/A Diclofenac 50mg – 20Voltaren cream – 2

11

Scorpion sting

1985M

The 27 year old patient was transported to K2 clinic from the nearly village.

Firs check at:23:00BP:172/125P: 112T:36,5

Spider bite by Latrodectus mactans (black widow)Overdoses of neuroleptics, Anticholinergics or tricyclic

Intense pain and swelling at the sting site (facial)Pins and needles to

ECG normal

0.9% NaCl infusion 500ml –

1Pirafene

(Chlorpheniramine) 5mg/ml – 1

Diazepam

Oxygen administration was provided for god ventilation support for adequate airway,


He was anxious and agitated complaining intense burning sensation to his face. He related that he was laying down in his bad when suddenly he felt a sting, and then noticed a scorpion. The patient complained to have headaches and nausea.

RR: 21O2 Sat: 98%

23:20130/94P: 84T:36,5RR: 17O2 Sat: 98%

23:59TA 134/95P: 80T:36,5RR: 21O2 Sat: 98%

antidepressantsNeurotoxic snakebiteThyroid storm, carcinoid or pheochromocytomaAlcohol withdrawalEncephalitisMeningitisMyocardial infarctionOrganophosphate poisoningPoliomyelitisSubdural hematomaTetanus

sting ereaTremors and muscle weaknessTachycardia, DysarthiaHeadaches, NauseaAnxiety

10mg/2ml – 1Metoclopramide 10mg/2ml – 1

Tramadol 100mg/2ml – 1Vaccine Titanic 0,5 ml IM – 1

Ibuprofen 400 mg – 10

Adol 500mg – 10Loratadine 10mg (1x1 daily) – 10Dermocal cream

– 1G20 IV Cannula –

1Infusion set – 15 ml Syringe – 52ml Syringe - 1

Needle – 6(Oxygen therapy)

ventilation and IV perfusion.

Monitoring the vital signs ( pulse oximetry; heart rate, blood pressure, and respiratory rate)

The symptoms disappear after one hour.

No tissue damage.

The patient refused to be transported to Suly clinic; he signed the “Personal Denial” form.

The patient got temporary accommodation in the Kelkan camp during the night in case of further intervention.

1 Acute tonsilis

1987

The patient complaints

BP:132/86P: 67

- Influenza- URI/LRI

Headaches, Nasal

N/A Azithromycin 500mg – 3

Avoid cigarette smoke and


M

sore troth and difficulty with swallowing. The sore troth starts two days before. He feeling of being tired and unwell.

T:36,2RR: 15

- Bacterial acute illness

- Gastroenteritis viral

- Pneumonia- Bronchopneumoni

a

drainage, FatigueSore trothpain in mouth with swallowingloss of appetitepus on the tonsils

Panadol cold & flu (all in one) –

10Orofar - 8

other irritants. Stay hydratedReturn for review after three days.

2 Ankle sprain

1980M

A 32 year old man (no previous history of ankle problems) sustained an acute ankle injury. The ankle was injured during playing football. The patient described instant pain without pop and the ankle felt weak. He was unable to continue to play but could walk with assistance to

BP:150/81P: 103T:36,1RR: 16

- Acute soft-tissue injury

- Lateral ligament sprains

- Peroneal tendon strains/dislocations

- Malleolar fractures - Fifth metatarsal

fractures- Physeal fractures- Achilles tendon

injuries- Tendinitis- Fracture and Stress

fractures- Neurovascular

compromise- High ankle sprain- Complex regional

pain syndrome (CRPS)

Swollen and and bruisingl to right ankle

N/A Tramadol 100mg IM – 1,

Elastic bandages – 3,

Ibuprofen 400mg – 10,

Piroxicam gel – 1, Orthopedic

walking crutch – 1pair

5ml Syringe – 1Needle - 1

Sent to Suly for Rtg. and orthopedic consultRecommendation: Ice pack should be applied with 15 minute intervals.


clinic. 3

Cold1946M

The patient complaints headaches starts few hours ago, feeling of being tired and, sneezing, watery eye feeling of unwell and slight sore troth

BP:143/94P: 81T:36,4RR: 15

- URI/LRI- Tonsillitis- Sinusitis- Influenza- H1N1 influenza- Pneumonia- Hayfever (allergic

rhinitis)

Headaches, Nasal drainage, FatigueSore troth

N/A Panadol Cold & flu (all in one) – 10Pectol – 8Vitamin C effervescent - 10

Recommendations:Stay hydrated, in case of fever or if the symptoms will get worst return for review.

4

Athlets foot (Tinea Pedis)

1966

The patient is a 46-year-old man with norelevant medical history was presented to K2 clinic with the complaint that his feet were very painful and itchy. Visual examination establishedthat he had contracted tinea pedis.

BP:146/96P: 85T:36,4RR: 15

- Candiadzis- Contact Dermatitis

Allergic- Dyshidrotic Eczema- Erythema

Multiforme- Friction Blisters

Red rash on the foot, Scaly skinBlisters ,Peeling skin, Intense itching,Burning sensation,Splitting of theskin between the toes, Skin swellingaround the rash

N/A Micoderm – 1 Recommendation:Apply the cream twice daily. The treatment should be continued at least one week after disappearance of all signs and symptoms.

5 Conjunctivitis

1971

41 year old man presents

BP:113/85P: 66T:36,9

- Blepharitis, Adult- Conjunctivitis,

Allergic

Itchy inflamed Red eyes

N/A Eyelox 10ml - 2 No purulent discharge.





http://www.freemd.com/rash-generalized/overview.htm

http://www.freemd.com/swelling/overview.htm

http://www.freemd.com/itching/overview.htm

http://www.freemd.com/blisters/overview.htm

http://www.freemd.com/rash-generalized/overview.htm

with a 1 day history of red, sore left eyes with itching (no purulent discharge)

RR: 15 - Conjunctivitis, Viral- Contact Lens

Complications- Episcleritis- Glaucoma, Angle

Closure, Acute- Keratoconjunctivitis,

Epidemic- Pharyngoconjunctiv

al Fever- Squamous Cell

Carcinoma, Conjunctival

- Uveitis, Anterior, Granulomatous

Tearing

6

Medication replacement

1978M

Medication replacement

N/A Medication replacement

N/A N/A Ramipril 5 mg – 10

Metoprolol 50mg – 30

Micardis plus – 56

Adol – 20Favar – 6

Asso Omar is the Communication Manager, who is responsible for villager’s health problems and for medication replacement as well.

7 UTI 1981M

The patient is a 31-year-old man who presents with a 48-hour history of needing to urinate frequently, and pain

BP:128/81P: 81T:36,1RR: 15

- Cystitis- Cystitis- Prostatitis- Urinary Tract Obstruction

- Epididymitis- Appendicitis- Pancreatitis- Sexually transmitted disease

- Dysuria- Fatigue- Burning

like pain during micturition

N/A Ciprofloxacin 500 – 10Diclofenac 50 mg – 10Cistone - 100

Return for review after five days.

















(burning or stinging) sensation when passing urine and is going to the toilet much more -frequently. He also thinks he may have seen blood in his urine but wasn't sure.

(STD)-

8

Children URTI

1998F

The patient is a 14-year-old girl who presents with a 24-hour history of headaches, low grade fever and sore troth. She feeling of being tired and unwell.

BP:105/59P: 146T:37,2RR: 18

- Influenza- URI/LRI- Pneumonia - Bronchopneumonia- Acute sinusitis

Headaches, Sore trothCough

N/A Amoxicillin 250mg/100ml – 1Panadol children

100ml – 1Vitamin C

effervescent – 20Pectol – 8

Tussilar - 10

Recommendations:Stay hydrated.Return for review after three days.

1 UTI 1982M

The patient is a 20-year-old man who presents with a 48-hour history of needing to urinate frequently, and pain

BP:128/81P: 81T:36,1RR: 15

- Cystitis- Prostatitis/ Prostate Hyperplasia

- Urinary Tract Obstruction

- Epididymitis- Appendicitis- Pancreatitis, Acute- Sexually transmitted disease

- Dysuria- Fatigue- Burning

like pain during micturition

N/A Ciprofloxacin 500 – 10Diclofenac 50 mg – 10Cistone - 100

Return for review after five days.







(burning or stinging) sensation when passing urine and is going to the toilet much more -frequently. He also thinks he may have seen blood in his urine but wasn't sure.

(STD)

2 Painful purulent wound at right finger hand,

Bloated- swollen finger, hand and

forearm

Wooden

splinter lesion

75-year-old man, the patient has caught himself on a sharp splinter (wooden) and he cannot to remove it, he has found it is too large and painful to remove. The patient complaining pain to his thumb finger at right hand. The patient declared just 24 hours history regarding the

BP:135/84P: 89T:36,3RR: 15

Laceration Foreign body sensation

"pus pocket,"Bloated- swollen finger, hand and forearm.

N/A Erythromycin 500mg 1x3 – 10Ibuprofen 400mg

– 10Adol 500mg – 10

Gentamicin cream – 1

Antibiotic gauze – 1

Elastic bandage – 3

Tetanus vaccine – 1

2ml Syringe – 120ml Syringe – 1

Needle – 1Surgical blades -

1

Return for follow-up care within 48 hours.Sent to Suly for surgical consultation (see if have recovered the entire wooden fragment)


http://www.mdguidelines.com/lacerations

event, but according to macroscopic investigation this most have at list 5 days.

3 Pain and stiffness

felt in muscles several hours to

days after

unaccustomed or strenuou

s exercise

Delayed onset

muscle sorenes

s (DOMS)

The patient complains swollen feeling sensation in thigh tissues, paresthesia, pain and stiffness felt in muscles several hours to days after unaccustomed - strenuous exercise.

BP:115/79P: 87T:36,5RR: 15

Muscle or tendon injury, Stress fracture, TraumaInflammatory MyopathiesAtherosclerosisPolymyalgia syndromes

Muscle tenderness and sorenessstrength loss, pain

N/A Diclofenac 50mg – 20Voltaren cream – 2Vitamin C effervescent - 10

Recommendation: Reduce the exercise, increases blood flow to the muscle, such as low-intensity work, massage, hot baths etc

4 ChildrenTonsillities

2004

A 8 year old boy presents to K2 clinic accompanied by his mother with a low grade fever, sore throat and difficulty

BP:97/72P: 80T:37,1RR: 19

- URI/LRI- Influenza- Pneumonia- Acute sinusitis- H1N1 influenza

Headaches, Sore trothpain in mouth with swallowing,pus on the tonsils

N/A Amoxicilline 250mg/80ml – 1Panadol syroup baby 100ml – 1

Pectol – 8Vitamin C

effervescent - 20

Stay hydratedReturn for review after three days.


http://en.wikipedia.org/wiki/Exercise

http://en.wikipedia.org/wiki/Muscle

http://en.wikipedia.org/wiki/Exercise

http://en.wikipedia.org/wiki/Muscle

with swallowing. The sore troth starts 2 day before. His tonsils appear swollen and red

5

Renal Calculus

1983

The patient was diagnosticated whit kidney stone 30 days befor, in the present the patient complaints sudden onset of excruciating, cramping pain in their low back and side.

BP:134/88P: 87T:36,2RR: 15

GallstonesRenal or ureteral stoneBacterial Acute abdomen (bowel, biliary, pancreas or aortic abdominal aneurysm sources)Orchitis

Kidney colic

N/A Diclofenac – 20Hyoscine – 10Cistone - 100

Drink 5 large glasses of water per day. Eat a low calcium diet. Strain your urine for kidney stones: use a paint strainer or cheese cloth, save the stones for analysis.In case of blood in urine, repeated vomiting, high fever or worsening pain (during urination) returns for review.

6 Thrush 1978

The patient complaints about a painful creamy white lesion presence in

BP:132/83P: 89T:36,1RR: 19

- Pharingitis- Candidasis- Diphtheria- Herpex Simplex

Virus- Immunodeficiency- Lymphohistiocytosi

Pain to his gums

N/A Oraxin mount wash – 1

Paracetamol - 10

Avoid cigarette smoke and other irritants. Stay hydrated. Fruits consumption.


his mouth. Visual examinations denote a creamy white slightly raised lesions to his gums . Visual examination establishedthat he had gum boll (Thrush).

s- Syphilis

7 Contact dermatiti

s

A 17 years old male complains of eczema, which comes and goes particularly during when hw providing his job (handling garbage). The skin itches, and patient has experienced no eczema previously. Patient

BP:120/81 P: 85T:36,4RR: 20

- psoriasis- seborrheic

dermatitis,- allergic contact

dermatitis,- nummular eczema- neurotic excoriation- scabies

Skeen rashSwellingItchingRed skeen

N/A Alfacort cream – 2

Loratadine 10mg - 5

Recommendations:

Use appropriated PPE (gloves), wash the hands frequently (being careful not to wash excessively or scrub the skin).

Use of ice bags or cool, wet compresses to relieve itch.


http://www.dermnet.com/

experiences itching in his booth hands. The eczema is symmetrical and occurs in both hands. They are itchy, without differentiation, the itching seems uncontrolled. He tends to feel hot and is irritable.

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Acute Diarrhea

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