decrease of counsciousness since 2 days before admission in RSSA after he drank some alcohol beverages (red label. Patient complained that he had nausea and severe vomiting after drinking the alcohol. 1 days before admission patient didnt look because very blurred vision. The father took the patient to the hospital. Patient had history of consuming alcohol since 7 years ago when in senior high school. There is no history of drug abuse. There is no history of hypertension and Diabetes Mellitus previously. Family history of any diseases (-) PHYSICAL EXAMINATION BP = 120/70 PR = 78 bpm, RR = 20 bpm Tax : 36 C mmHg strong, regular General appearance looked GCS 456 moderately ill Head Anemic - Icteric - Visus 1/300 . Light reflex (-) Neck JVP R + 0 cm; 30 Thorax: Ictus invisible, palpable at ICS V MCL Sinistra Cor: LHM ictus RHM SL Dextra S1, S2 regular, with no murmur Symmetric, SF D = S, v v Rh - - Wh - - Lung: vv -- -- vv -- -- Abdomen Flat, soefl, liver span 10 cm, troube space tympani, BS (+) N LABORATORY FINDING Lab Value Lab Value Leukocyte 15.000 3.500- Diff count 0,1/0,3/7 10.000/L Eosinofil/ba 9,4/11,9/ sofil/netrofil/ 8,3 limfosit/mon osit Haemoglobin 19.40 11,0-16,5 Kalium 2,5 e g/dl PCV 54.40 35-50% Chlorida 100 Trombocyte 193.00 150.000- 0 390.000/L MCV 87,30 Ureum 58,9 10-50 mg/dL MCH 31,10 Creatinine 1,34 0,7-1,5 mg/dL BLOOD GAS ANALYSIS BGA Value ( 4L O2 )
PH 7,33 7,35-7,45
PCO2 27,3 35-45
PO2 79,5 80-100
HCO3 14,4 21-28
O2 saturation 94,8% > 95%
Base Excess - 11,8 -3 until +3
Conclusion Metabolic acidosis
ECG CXR CUE AND CLUE PL IDx PDx PTx PMo male/25 yo 1. 1.1.Intoxicat Ethanol O2 2-4 L/NC Subjectiv Decrease of Alkohol ion blood IVFD NS 0,9%: D5 % : e counsciousness intoxicati methanol level, 20 tpm BP,GCS, consume on mixed metan Gastric lavage PR, RR, alkohol ethanol ol Loading ethanol 50 % BGA, Blurred vision 1.2.Intoxicat blood (75 ml) in D5% RBG,urin Physical ion ethanol level solution via NGT e examination: Continued 0,5 producti Visus 1/300, ml/kgBW for every 2 on light reflek (-) hours for 4 days GCS : 456 BP: 120/70 mmhg PR: 78 bpm RR: 20 bpm Laboratory: BGA: metabolic acidosis PH: 7,33 HCO3: 14,4 mmol/l CUE AND CLUE PL IDx PDx PTx PMo
Male/19 yo 2. Blurred 2.1Due to Fundusco Tiamin 3 x100 mg iv VS,
Blurred vision vision no 1 py Dexamethason inj subj History of (toxic refer to 1x40 mg (iv). ectiv consume alcohol optic optalmolo e neuropat gic hy) departme nt Male / 19 yo 3. Azotemia 3.1 CCT, Equal fluid balance Ur,C Laboratory prerenal abdominal infus NS r Ureum: 58,90 dt usg 20cc/kgbw/hour Creatinin: 1,34 inadequat Leukoasit: e renal 15.000 perfusion (dehidrati on) 3.2 renal 3.2.1 AKI stage III Thank you