63M farmer with abdominal distension, pedal edema, quadreparesis

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63 year old male farmer 




ON EXAMINATION:-

Pallor+
No icterus, cyanosis, clubbing edema , lymphadenopathy.
VITALS ON ADMISSION:- 
Temp:- 101F 
PR:- 92 BPM
RR:-14 cpm
BP: 90/60 MMHG
Spo2:- 83 % at RA
GRBS:- 195 MG%
CVS:- S1 S2+ ,NO MURMUR
RS:- BAE+ , NVBS+
P/A SOFT ,NT
CNS:- Eye opening to pain
 No verbal response
No meningeal signs
GCS:- E2 V1 M5. 8/15
PUPILS--B/L mid dilated unequal(Rt>Lft)
Plantars-- B/l Flexion 
Power- --. RT. LT
 Upper limb - 5/5. 5/5
 Lower limb- plegia plegia(0/5)
Tone --
 Upper limb- Increased.Increase
 Lower limb- Decreased.decreased.
Reflexes:- RT. LFT
            B- absent. 2+
            T-. 3+. 3+
            S-. 2+. 2+
            K-. Absent. Absent
            A-. Absent. Absent.

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