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Brugada Group 6 Ateneo School of Medicine and Public Health.

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Presentation on theme: "Brugada Group 6 Ateneo School of Medicine and Public Health."— Presentation transcript:

1 Brugada Group 6 Ateneo School of Medicine and Public Health


3 MS 25 years old Male Filipino Roman Catholic Pasig City Informant: Self Reliability: Very Good General Data

4 Loss of consciousness Chief Complaint

5 30 minutes PTA Riding a motorcycle with companion Chest discomfort described as tightness, diffuse, non- radiating, 6/10 severity with associated dyspnea lasting 30 seconds Stopped bike on sidewalk where vision dimmed Loss of consciousness lasting 2 minutes No headache, vomiting, dizziness, weakness, numbness No stiffening of extremities or drooling History of Present Illness

6 28 minutes PTA Pt regained consciousness, was diaphoretic Chest pains continued Was picked by a serendepititiously located RedCross van and rushed to TMC History of Present Illness

7 General ◦(-) Fever, (-) Weight changes, (-) Fatigue Musculoskeletal/Dermatologic ◦(-) Itching, (-) Muscle/joint pains, (-) Rashes HEENT ◦(-) Vision/hearing problems, (-) Epistaxis/gum bleed, Respiratory ◦(-) Hemoptysis, (-) Cough, (-) Wheezing Review of Systems

8 Cardiovascular ◦(-) Orthopnea, (-)PND Gastrointestinal ◦(-) N/V, (-) Dysphagia, (-) Heartburn, (-) Change in bowel habits, (-) Rectal bleed, (-) Jaundice Genitourinary ◦(-) Nocturia, Dysuria, Frequency, Hematuria Endocrine ◦ (-) Heat intolerance, (-) Polyuria, (-) Excess thirst, (-) Cold intolerance Review of Systems

9 Nonspecific abnormal ECG, 2008 For pre employment Initially diagnosis unrecalled ECG repeated which turned out normal Head trauma, January 2010 Sustained while lifting machinery Causing bleeding, necessitating stitches No loss of consciousness, vomiting, or neurological sequelae Past Medical History

10 (+) Asthma, father's side (+) Hypertension, father's side (+) Myocardial infarction, father's side (+) DM, mother’s side (+) Stroke, mother’s side (+) Leukemia, mother's side (-) PTB, Kidney Disease Family History

11 College graduate Systems developer Cohabiting, no children Current smoker (2 pack years) Occasional alcohol beverage drinker (3 / month max 3 bottles) No history of illicit drug use Personal/Social History


13 General ◦Alert, coherent ◦Height 166 cm, Weight 68 kg, BMI 24.7 Vital Signs ◦BP 110/80, HR 88, RR 19, T 37.1 C Skin ◦pink, no rashes/scars/lesions Physical Examination

14 HEENT ◦Normocephalic ◦Anicteric sclerae, Pink palpebral conjunctivae ◦Moist pink lips, pink buccal mucosa ◦(-) Nasal discharge, (-) facial tenderness ◦(-) TPC, (-) CLAD, non distended neck veins Physical Examination

15 Respiratory ◦Symmetric chest expansion ◦Resonant chest wall ◦(-) Rales, rhonchi, wheezes Cardiovascular ◦PMI 5th ICS LMCL ◦Normal rate, regular rhythm ◦Distinct S1 and S2, (-) Murmurs Physical Examination

16 Abdominal ◦Flat abdomen ◦Normoactive bowel sounds ◦Tympanitic on percussion ◦No tenderness on light and deep palpation ◦No organomegaly Extremities ◦Full and equal pulses ◦CRT <2s, no cyanosis Physical Examination

17 Neurologic ◦Cranial Nerves intact ◦Motor 5/5 on upper and lower extremities ◦Sensory - no deficits Physical Examination

18 CBC Electrolytes Thyroid Function Tests CKMB, CKMM, CK Total PT, PTT Creatinine, Uric acid, Lipid Profile CBG: 97 Diagnostics

19 PEFR Measurements NebulizationBest PEFRPercent Best (350) Pre250 200 20071 % 1250 240 25071% 2250 250 25071% 3300 250 30086%

20 PARAMETERRESULTNORMAL VALUES Hgb162115-135 g/L Hct.490.36-0.47 RBC4.2-5.4 WBC10.24.5 - 10 x 10^9/L PC253140 - 400 x 10^9/L Differential Neutrophil.71.56-.66 Lymphocyte.26.22-.40 Monocyte.04-.08 Eosinophil.01-.04 Complete Blood Count

21 PARAMETERRESULTNORMAL VALUES Na141 K3.0 Mg1.85 Ca5 Creatinine.84 Uric acid6.61 APTT28.831.2 PT13.413.3 PTT Blood Chemistry

22 PARAMETERRESULTNORMAL VALUES CK Total337.2 CK MM304.7 CK MB32.7 Trop TNegative TSH3.4 FT33.01 FT41.22 Blood Chemistry

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