2nd degree Paralytic lieus
SCENARIO: A 50 year old female presented to the OPD with SOB and constipation. COMPLAINTS AND DURATION Constipation since 3 days Pain in abdomen Shortness of breath Nausea and vomiting since 3 days Pain in chest since 2 years HISTORY OF PRESENT ILLNESS Patient apparently asymptomatic 2 months ago, developed shortness of breath, pain in abdomen(right side tenderness and right hypochondriac pain) and constipation.This was followed by 4 episodes of vomiting HISTORY OF PAST ILLNESS Not a K/C/O HTN, DM, asthma, epilepsy Renal caliculi treated conservatively 2 years ago TREATMENT HISTORY No significant treatment history PERSONAL HISTORY Appetite - Normal Bowels- Constipated Micturition -Normal No known allergies No addictions FAMILY HISTORY No significant family history MENSTRUAL HISTORY Hysterectomy done 15 years ago for fibroid bodies PHYSICAL EXAMINATION GENERAL Pallor - Yes Icterus - No Cyanosis - No Clubbing of finger/toes - No Lymphadenopathy - No Oedema - No Temperature - afebrile