Pre-finals(paper-2)

 




























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A 14 year old with shortness of breath since 2 days

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  This is a case of a 14 year old girl who came with chief complaints of: Shortness of breath since 2 days Fever since 1 day Abdominal pain since 1 day Vomiting 1 episode HOPI:  The patient was apparently asymptomatic 4 years ago, then she had a fever with generalised body weakness and polyuria and was diagnosed having type 1 DM and started on insulin. 2 years ago patient had similar complaints after an episode of fever and was admitted at our hospital and was treated here.   2 days ago then she developed sudden onset shortness of breath since 2 days, gradually progressive and progressed to stage 4. Shortness of breath started after patient missed taking 2 doses of insulin. No orthopnea, no PND.  Fever since 1 day, high grade associated with chills and rigors, relieved on taking medication, no diurnal variation. Abdominal pain since 1 day epigastric region alter progressed to diffuse abdominal pain. No h/o vo...
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