CASE PRESENTATION

DR UZMA RANA
PGR G1

CASE SUMMARY
UB , 28yr, PG at 8 months of
Gestation al Amenorrhea(received
IUD) , with Acute Fulminant Hepatic
Failure in DIC.

HISTORY
BIODATA:
UB, 28YR, UNEDUCATED, HOUSEWIFE
RESIDENT OF SHAH PUR.
PRESENTING COMPLAINTS:
FEVER & JAUNDICE ------ 3DAYS
ALTERED SENSORIUM----- 1DAY

HISTORY
PT WAS IN USUAL STATE OF HEALTH 3DAYS
AGO , WHEN SHE DEVELOPED FEVER WITH
YELLOW DISCOLORATION OF BODY,
FOLLOWED BY TREATMENT FROM LOCAL
DOCTOR , FOLLOWED BY ALTERATION IN
SENSORIUM FOR 1DAY. PT WAS BROUGHT
TO L/R-1 JHL ON 7-07-2014 AT 1AM .
NO H/O HTN, DM, HEPATITUS
NO H/O ANY SURGERY
NO PREVIOU HOSPITALIZATION

HISTORY
NO H/O ANTENATAL VISITS TO ANY
HOSPITAL/CLINIC
NO H/O JAUNDICE IN OTHER FAMILY
MEMBERS
POOR SOCIO-ECONOMIC STATUS

EXAMINATION
GPE:

YOUNG LADY OF AVERAGE BUILT AND

HEIGHT LYING DROWSY IN BED
GCS 15/15
PALLOR +
JAUNDICE +++
CYANOSIS VE
PEDAL OEDEMA +

EXAMINATION
GPE:
A YOUNG LADY OF
AVERAGE BUILT
&HEIGHT,DROWSY
LYING IN BED
PULSE104/M
BP110/70MM/HG
R/R20/M
TEMP98.6F

PALLOR +
JAUNDICE +++
CYANOSIS VE
OEDEMA VE
GOITRE VE
JVP NOT RAISED

EXAMINATION

P/A EXAM :
SOFT
SFH--TERM
L/C
LIQOUR ADEQUATE
FHS ABSENT
EFW2.8KG
P/P4/5PALPABLE

P/V EXAM:
OS CLOSED
CX FULL LENGTH
FIRM, POSTERIOR
VX HIGH
PELVIS ADEQUATE

EXAMINATION
SYSTEMIC REVIEW:
S1+S2+0
NORMAL VESICULAR BREATHING,
BILATERAL AIR ENTRY NORMAL
ALTERED SENSORIUM
OTHER SYSTEM SEEMED TO BE
UNREMARKABLE.

INVESTIGATIONS

07-07-2014(1:00AM) 07-07-2014(4:00PM)
HB 9GM/DL
8GM/DL
TLC 12,000
PLATELETS 41,000
1,51,000
BSR 32MG/DL 82MG/DL
ANTI-HAV IGM +VE
ANTI-HEV IGM
+VE
ANTI-HCV AB
--VE
HBsAG
--VE
PT
>1MIN >1MIN(AFTER TRANSFUSIONS OF 4
FFPS)
APTT
>1MIN >1MIN

INVESTIGATIONS
07-07-2014 AT
1:00AM

07-07-2014 AT
4:00PM