Example Assessments

1. Acute on CKD

• Dehydration

• Sepsis

• HD naive

• No oliguric

• No metabolic acidosis

• No hyperkalemia

2. HAP with type 1 respiratory failure

• ETT cnS 2/1/19 Acinobacter XDR

• Completed IV Unasyn high dose

• Blood CnS (2/1/19 So Far No Growth

• ETT CnS 12/1/19 No Growth

• TWC reducing trend

• CRP 180 > 50 > 30

• Status Afebrile

3. Dengue fever with warning sign

 • D4 of illness

• Febrile phase/ Entering critical phase (15 Hour

Afebrile)

• Not in shock

• Hemodynamically stable

4. Acute coronary Syndrome

• Based on Clinical symptom

• No ECG changes

• TIMI

• Cardiac Enzyme – pending (Kalau CE raised : Non

STEMI, Kalau CE not raised : Unstable Angina,

kalau pending: ACS)

• Not in failure

5. Non STEMI

• TIMI?

• CKMB/CK ratio 17% > 7% ( Reduce in trend)

• On IVI Heparin / Sc Fonda Day 3

6. Chronic Atrial Fibrillation

• Previously on T Dabigatran/ T Warfarin/ T

Apixaban

• Currently rate controlled

• HASBLED ?

7. End Stage Renal Failure with regular HD

• Last HD 3/1/19

• Completed 3 Hour, uneventful/ Complicated

with intradialytic Hypotension, started on single

inotrope

• Via Right BCF/ AVF/ Right IJC/ Left Femoral etc

• Oliguric, metabolic acidosis, hyperkalemia

• Awaiting HD due today

• With I pint pack cell tranfusion

8. Normocytic Normochromic Anemia secondary

to chronic illness

• No active bleeding

• Hb : static 9.2 -- 9.1

• Stool occult blood negative

9. Community Aqcuired Pneumonia with

bronchospasm

• CURB ?

• On Neb Salbutamol 4 Hourly

• Status : improving

• On IV Tazosin/ Unasyn/ Augmentin day 3

(depends on sensitivity and severity)

10.Septicemic shock secondary to CAP/infected

sacral sore with type 1 resp failure

• CURB ?

• Hemodynamicall supported with single inotrope

• TWC increasing trend.

• CRP 200

11.Raised transaminases for IX

Ddx :

• Deranged liver enzyme secondary to 1(eg dengue)

• Drug induce

• Acute ischemic hepatitis

• Status LFT : worsening (AST/ALT)

12.Unilateral Left Lower limb swelling

Ddx

DVT

Soft Tissue Swelling secondary hypoalbuminemia (Alb 20

Cellulitis

13.Unstable angina with LV failure ppt by HPT

Ddx anemia induce angina

» Status - angina free

» TIMI 2

» On double antiplatelet

» On SC Fondaparinux 2.5mg Day 2