45F WITH PARAPARESIS SINCE 4 DAYS

This is online E log book to discuss our patient’s de-identified health data shared after taking his/her/guardian’s signed informed consent. Here we discuss our individual patient’s problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs. This e-log book also reflects my patient centered online learning portfolio and your valuable inputs on comment box is welcome .


Chief Complaints:

45 year old female present led to casualty with c/o weakness in both upper limbs and lower limbs since 4 days. 

HOPI: 

Patient was apparently asymptomatic 4 days back and she developed weakness of both upper limbs and lower limbs but she managed to do her daily activities at home but today morning when she got up from sleep she could not walk and had a fall. Then she came to our hospital in ambulance. In ambulance her BP was 170/8mHg so the driver have Inj. lasix

Past History: 

No similar complaints in the past 
N/k/c/o HTN, DM, EPILEPSY, TB, ASTHMA

H/O b/l renal calculi 
H/o TAH with B/l salpingoopherectomy on 23/3/23

Soap notes  
31/5/2023

S:  
Pt subjectively doesn't feel any better than yesterday. 
No fresh complaints 

O:
Pt is c/c/c
BP: 130/80mmhg
PR: 72bpm
RR: 20cpm
CVS: S1 s2 heard , no murmurs
RS: B/L air entry present NVBS + 

A:

PARAPARESIS UNDER EVALUATION
SECONDARY TO HYPOKALEMIA? ( RENAL LOSS)

P:
Inj. Optineuron 1 amp in 100ml NS/ IV /OD

Inj. KCL 2amp in 500ml NS IV

Syp. POTCHLOR 15ml PO/ TID in 1 glass of water

Potassium rich diet

Soap notes  
1/6/2023

S:  
Generalised weakness of lower limbs reduced compared to yesterday, according to patient 


O:
Pt is c/c/c
BP: 130/80mmhg
PR: 74 bpm
RR: 20cpm
CVS: S1 s2 heard , no murmurs
RS: B/L air entry present NVBS + 

A:

PARAPARESIS UNDER EVALUATION
SECONDARY TO HYPOKALEMIA? ( RENAL LOSS)

P:
Inj. Optineuron 1 amp in 100ml NS/ IV /OD

Inj. KCL 2amp in 500ml NS IV

Syp. POTCHLOR 15ml PO/ TID in 1 glass of water

Tab. DROTIN -P PO/SOS 

TAB. PAN 40mg PO/OD 

Ayo. ALKATRON B6 15ml PO/BD 

Potassium rich diet

Soap notes  
2/6/2023

S:  
Generalised weakness of lower limbs reduced compared to yesterday, pt is not able to walk without support slowly.
Pt subjectively feels much better from the day she came


O:
Pt is c/c/c
BP: 100/70mmhg
PR: 84 bpm
RR: 16cpm
CVS: S1 s2 heard , no murmurs
RS: B/L air entry present NVBS + 

A:

PARAPARESIS UNDER EVALUATION
SECONDARY TO HYPOKALEMIA? ( RENAL LOSS)

P:
Inj. Optineuron 1 amp in 100ml NS/ IV /OD


Syp. POTCHLOR 15ml PO/ TID in 1 glass of water

Tab. DROTIN -P PO/SOS 

TAB. PAN 40mg PO/OD 

Ayo. ALKATRON B6 15ml PO/BD 

Potassium rich diet



Serum potassium on 2/6/23 is 3.4

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