55 yr old female with hypoglycemia

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I have been given this case to solve in an attempt to understand the topic of "Patient clinical data analysis" to develop my competency i reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan

1701006011

A pavan kumar 

A 55 yr old female came to the casualty with chief complaints of 

1) loss of consciousness since 30 min associated with palpatation and sweating 

HOPI 

she was asymptomatic 30min back then she developed loss of consciousness associated with palpatation and sweating 

She developed the same episode of loss of consciousness 12 days back that is due to some medication (beta blocker) but the present episode of loss of consciousness is not proceeded by medication 

She is the known case of diabetes and hypertension since 2 years she was taking medication of diabetes.

O/E 

At the time of admission patient was not consious coherent and cooperative 

On admission 12 am vitals are 

Bp 130/60 

Pulse 57

RR 16 

Temperature 98.8

Spo2 91%ra

Grbs 44

INVESTIGATIONS

DIAGNOSIS

HYPOGLYCEMIA UNDER EVALUATION 2' TO OHA.

TREATMENT 

1) IV 25D 100 ml stat 

2) NS 75ml / hr 

3) inj octreotide 100mg sc stat 

4) 25 D 50ml / hr

5) metformin 500mg po BD