Nuerology 2C

Case 3: 
Link to patient details:
3) Did the patients history of denovo HTN contribute to his current condition?
Answer: No


4) Does the patients history of alcoholism make him more susceptible to ischaemic or haemorrhagic type of stroke?
Answer: Yes, Atrial fibrillation and alcohol Drinking excessive amounts of alcohol can trigger atrial fibrillation – a type of irregular heartbeat. Atrial fibrillation increases your risk of stroke by five times, because it can cause blood clots to form in the heart. If these clots move up into the brain, it can lead to stroke.

3)THIRD CASE: A 45 YEARS OLD FEMALE PATIENT WITH PALPITATIONS, PEDAL EDEMA, CHEST PAIN,CHEST HEAVINESS,RADIATING PAIN ALONG LEFT UPPER LIMB

C) Link to patient details:

http://bejugamomnivasguptha.blogspot.com/2021/05/a-45-years-old-female-patient-with.html


Questions:

1) What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patient's problem?
Answer: Patient was normal 8 months back then developed b/l pedal edema which gradually progressed.
• Palpitations :since 5days, sudden in onset which is more during night
Aggerevated by lifting heavy weights, speaking continuously
•Dyspnoea during palpitations (NYHA-3) since 5 days
•pain:since 6days, radiating along left upper limb, more during palpitations and relived on medication.
•Chest pain associated with chest heaviness since 5 days

2) What are the reasons for recurrence of hypokalemia in her? Important risk factors for her hypokalemia?
Answer: Reason: recurrent hypokalemic periodic paralysis
•Risk factors: Risk factors associated with a low serum potassium levels (hypokalemia) include female gender, intake of medication (diuretics), heart failure, hypertension, low body mass index (BMI), eating disorder, alcoholism, diarrhea, Cushing's syndrome.

3) What are the changes seen in ECG in case of hypokalemia and associated symptoms?
Answer: ECG changes include flattening and inversion of T waves in mild hypokalemia, followed by Q-T interval prolongation, visible U wave and mild ST depression4 in more severe hypokalemia. Severe hypokalemia can also result in arrhythmias such as Torsades de points and ventricular tachycardia.
Associated symptoms: 
Weakness and fatigue (most common)
Muscle cramps and pain (severe cases)
Worsening diabetes control or polyuria.
Palpitations.
Psychological symptoms (eg, psychosis, delirium, hallucinations, depression)

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