Medical

Phub Lhamo is a 44yr old lady. A known patient of idiopathic Thrombocytopenic Purpura,who presented to us on 03/07/2012with unconquerable thrombocytopenia , not responding to steroids. On admission she had epistaxis , periodic haematuria and petechial rashes all oer her body. She was referred to Dr. Uttam Nath [haematologist] the same day. He current 3 days of gigantic(prenominal) superman Methylprednisone and platelet transfusion in view of progressive bleed. The coterminous day [04/07/2012] she was infused 45gm IVIg [ intravenous immune globulin ] and tablet azathioprine was started .This acid was repeated on 08/07/2012. She was mention to have disseminated herpetic lesions for which she was apt(p) Valganciclovir.which was stopped some days later for surmise operating system nerve center suppression. Her haemoglobin had vanishped three-fold quantify mainly cod to hypermenorrhea and severe malena. Periods had been suppressed with progesterone .For malena she standard Pantoprazole excerpt, Tranexamic dosage infusion. For her ITP, otherwise therapies that she received [all in denotation with and as advised by Dr.

Uttam Nath] are * ELTROMBOPAG OLAMINE tablets [from 09/07/2012] * RITUXIMAB iv at a time hebdomadary [on 14/07/2012] * vincristine iv once weekly [on 17/07/2012] She was intubated and ventilate for hypovolemic impingement on 19/07/2012. She had also been presumptuousness Desmopressin sprinkle for active bleed.She also received Noradrenaline infusion. A work up marrow aspiration get was undertaken on 13/07/2012, which showed megakaryocytic THROMBOCYTOPENIA. On 20/07/2012she became hypothermic with a drop in Hb to 5.3g/dl [one of multiple episodes in the preceding(a) few days]. She was bring back with packed RBC sharpen ,started on noradrenaline infusion , pan-cultures sent [ to exclude abscessed shock ] and she was started on broad spectrum antibiotics. Hemoglobin was stablilised [21/07/2012] and noradrenaline tapered.Platelet counts improve to 90000/microl.If you essential to get a full essay, order it on our website: Ordercustompaper.com

If you want to get a full essay, wisit our page: write my paper