1601006182 SHORT CASE

 

FINAL MBBS EXAM- SHORT CASE - 1601006182

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CASE :

A 14yr old male, who is a student resident of Nalgonda came with chief complaints of

. Fever since 8 days

. Cough since 8 days

. Shortness of breath since 8 days. 

History of present illness :

The patient was apparently asymptomatic 8 days ago, then

. He developed fever, which was insidious in onset, low grade, continous, associated with chills and rigor and relieved on medication. 

. He developed cough, which was insidious in onset, not associated with expectoration and no aggravating and relieving factors. 

. History of shortness of breath, which is insidious in onset, progressed from grade 1 to grade 2 (according to MRMC), aggravated on exertion and relieved on sitting position. 

RESPIRATORY SYSTEM EXAMINATION :

INSPECTION - 

. Trachea central

. Expansion of chest decreased on left side. 

PALPATION -

. Trachea central in position 

. Expansion of chest decreased on left side

PERCUSSION :

. Dull note on left interscapular area, infrascapular area and infra axillary area. 

AUSCULTATION :

. Decreased breath sounds on left side. 

. Diminished vocal resonance in left infrascapular area, infra axillary area interscapular area. 

INVESTIGATIONS : 

Chest X-ray 

PROVISIONAL DIAGNOSIS :

Left sided pleural effusion.