70year old male with HHS with DIABETIC CHOREA
New admission Unit4:
70yr old male ,agricultural labourer by occupation, presented with weakness of right upper limb and lower limb and difficulty in walking since 3days with involuntary movements of right upper limb.
C/o slurring of speech since 3days .
C/o increased frequency of micturition since 10days.
K/c/o type2 DM since 5months ...not on any medication.
K/c/o CKD (no records found)
Known alcoholic since 20yrs
H/o left hip surgery 5months back due to fall .
O/E :
Pt c/c/c
Bp-140/80mmHg
PR- 90/min,regular ,normal volume
RR- 16cycles/min
Spo2-98% @room air
Involuntary movement in rt U/L
CNS Examination
Pupils -NSRL
Power 4-/5 in both upperlimbs
4+/5 in both lowerlimbs
Tone -hypertonia+ in all 4limbs
Reflexes -brisk in all four limbs
Plantars- mute
CVS-S1S2+ no murmers
Resp-NVBS+
P/A -soft ,NT,no oraganomegaly
Investigations : blood sugars "Hi"in glucometer.(sent sample for RBS)
Urine for ketones -negative
Waiting for other reports
Provisional diagnosis: ?HHS with DIABETIC CHOREA