Perform a differential diagnosis

Reference no: EM133329079

Case: A 46 years old female entered the infectious hospital on 24.08.2019, 6 hours from the beginning of disease with a diagnosis of acute gastroenteritis.

Complaints: On a weakness, dryness in the mouth, cramps in gastrocnemius muscles, frequent stool to 20 times from the beginning of illness, vomiting. Anamnesis of illness: she became ill acutely at night on 24.08.2019, when frequent urges on defecation and rumbling in a stomach appeared. In two hours vomiting without previous nausea like a "fountain" occurred, then cramps in the calves appeared. Anamnesis of life: she works as an instructor in a tourist agency. She does not remem ber what illnesses she had in childhood. Allergological anamnesis is negative.

Epidemiology anamnesis: the day prior to the disease she got back from a week-long tourist journey to Odessa city. She was swimming in the sea, washed fruits by sea water.

Objectively: The general state is severe, temperature is 35,4°C. 60 kg patient. The skin is cold, pale. Lips are cyanotic. The lines of the face of the person are sharp. The mucus membranes of the mouth and the tongue are dry. Voice is hoarse, quiet. The turgor of the skin is decreased; a fold on the skin of the abdomen falls out slowly. BP is 60/40 mm Hg. Heart sounds are muffled. The pulse is 88 beats per minute, thread like, of weak filling. The abdomen is falling back, painless. The liver and the spleen don't come forward from under the costal arc. Stool is of liquid feces of white color, odorless. Last time the woman excreted 100 ml of urines 2 hours prior to the hospitalization.

Question 1. Make and explain the diagnosis.

Question 2. What illnesses is it necessary to perform a differential diagnosis with?

Question 3. What is the primary treatment?

Question 4. What auxiliary methods of research must be used for diagnosis of this disease?

Question 5. Calculate the dose of injected fluid for the patient.

Reference no: EM133329079

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