A 60F with megaloblastic anemia
DOA - 27/11/2023 CHIEF COMPLAINTS Fever since 1 week Palpitations since 1 week Generalised weakness since 4 days Chest pain and tightness since 4 days HISTORY OF PRESENTING ILLNESS The patient was apparently asymptomatic 1 week ago and then she developed fever which is sudden in onset, high grade, associated with chills and rigors, relieved temporarily on medication. Palpitations are present since 1 week which are regular and associated with chest discomfort. There is H/o shortness of breath on exertion which is progressive (grade 2 to grade 3). No orthopnea, or PND. There is associated generalised weakness since 4 days and blood in stools since 3 days. There is no h/o vomitings, loose stools, pain abdomen, giddiness. PAST HISTORY N/k/c/o DM, HTN, Asthma, TB, Epilepsy, CAD, CVA There is h/o tubectomy PERSONAL HISTORY Diet mixed Appetite normal Sleep adequate Bowel and Bladder-regular Addictions - None GENERAL EXAMINATION Pt is conscious, coherent and cooperative and well orie