? HYPOKALEMIC PERIODIC PARALYSIS
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Past history -
K/C/O - Diabetes mellitus (since 12years)
Patient is using insulin two times per day.
15U before breakfast and 10U in the evening.
He had a history of fall 1 year ago and 4 months back he was having right hip pain which is insidious on onset,aggregated on movement and relieved on medication/rest.
One month ago, an episode of haematuria for 5 days but patient didn't went for checkup.
2 days back he was having weakness in his both lower limbs majorily right and there by he needed some assistance to walk and sit up and eventually to feed.
N/K/C/O - HTN,CAD,ASTHMA,TB and EPILEPSY.
Smoker - For 10 years,1-Beedi/day and paused it 4 years ago and resumed one year back.
Alcohol - For 25 years and stopped drinking when he was diagnosed with DM
He used drink continuously for 10days and stop for 20days and repeat it every month.
Diet - Mixed
Appetite - Normal
Bowel - Regular
Micturition - Normal.
No known allergies.
CVS - S1S2+ and No thrills and No cardiac murmurs.
HOW AVN OF FEMUR GOT DIAGNOSED AND TREATED?
Patient had a h/o fall one year back he was normal all long but there was change in gait which was observed by patient and his attenders one month ago and when he went for checkup on (29/05/22) he was diagnosed with AVN of femur and given medications are as follows :
TAB.GABAPENTIN(40mg)&NOTRIPTYLINE (10mg)
TAB.PANTOPRAZOLE(40mg)&DOMEPERIDONE(30mg)
TAB.ETORICOXIN (60mg)&
THIOCOLCHICOSIDE (4mg)
TAB.METHYL COBALAMIN,ALPHA LIPOIC ACID BIOTIN PURIDOCINE AND FOLIC ACID
TAB.FERROUS ASCORBATE,FOLIC ACID AND ZINC TABLETS.
SCANS ON 29/05/22
On 1/6/22 he had developed generalised weakness and couldnt feed himself not a/w dysphagia.
On 02/06/22 (came to OPD)
Bp - 120/80mmhg
PR - 92bpm
RR -17cpm
SpO2 -97%
GRBS - 150mg/dl
GCS - E4,M6,V5.
Not associated with fever,SOB and chest pain.
Provisional diagnosis on 2/6/22
? hypokalemic periodic paralysis
TREATMENT GIVEN
ON 3/6/22
c/c/c and afebrile
CVS - S1 S2+
CNS - Sensorium improved
P/A - soft and non tender
stools passed 4 days back.
ON USG
Rt kidney - 8.8 * 4.2 cm
Lt kidney - 10*3.6 cm
Size is normal but increased echotexture
CMD - partially maintained
Spleen - 12.9cm (increased)
FINDINGS ON USG
Multiple intraductal and parenchymal calcification noted in pancreas involving and head and pancreas.
8mm calculus noted in inferior pole of left kidney.
Distended gall bladder with calcification noted of 6mm.
IMPRESSIONS ON USG
• Cholelithiasis with GB sludge
• chronic pancretitis
• left renal calculus
• mild splenomegaly
• B/L grade - II RPD changes
• minimal ascitis
Provisional diagnosis on 3/6/22
? Hypokalemic periodic paralysis
? Lt pneumonia
TREATMENT GIVEN
ON 4/6/22
c/c/c and afebrile
BP - 120/80mmhg
PR - 88bpm
CVS - S1 S2+
CNS - Sensorium improved
R/S - BAE + and LT CREPTS +
P/A - soft and non tender.
Provisional diagnosis on 4/6/22
? Hypokalemic periodic paralysis
? Lt pneumonia
TREATMENT GIVEN
ON 5/6/22
c/c/c
BP - 100/60mmhg
PR - 92bpm
CVS - S1 S2+
CNS - Sensorium improved
R/S - BAE + and LT CREPTS +
P/A - soft and non tender.
Provisional diagnosis on 5/6/22
? Hypokalemic periodic paralysis
? Lt pneumonia
TREATMENT GIVEN
CHARTS
RANDOM BLOOD SUGAR
SERUM ELECTROLYTES
SERUM CREATININE
INVESTIGATIONS
ECG ON 2/6/22
ECG ON 3/6/22
ECG ON 4/6/22
REPORTS ON 2/6/22
CLINICAL IMAGES 
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