internal assessment-II Paper -2



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NEUROLOGY(D)

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  A1. Occurrence of seizure due to brain stroke: ·          Cells in the brain send electrical signals to one another ·          The electrical signals pass along your nerves to all parts of the body ·          A sudden abnormal burst of electrical activity in the brain can lead to the signals to the nerves being disrupted, causing a seizure ·          This electrical disturbance can happen because of stroke damage in the brain. ·          A seizure can affect vision, smell and taste, loss of consciousness and jerking movements. Mechanism of seizure activity: ·          You’re more likely to have a seizure if you had a haemorrhagic stroke (bleed on the brain). ·          Seizures can also be more likely if you had a severe stroke, or a stroke in the cerebral cortex, the large outer layer of the brain where vital functions like movement, thinking, vision and emotion take place. ·          Some people will have repeated seizures, and be diagnosed with epilepsy. ·          The
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INFECTIOUS DISEASE HEPATOLOGY(B)

 A1. Most likely cause is Amoebic liver abscess because of the following findings:             - Age of the patient             - Single abscess             - Right lobe involvement A2.  - right hypochondriac and epigastric pain , fever ➡ can be liver, biliary or right lower lobe pneumonia -Invesigations:          -CBP : Leucocytosis          -LFT : Elevated Alkaline phosphatase          -RFT           -Urine analysis           -USG : Single hyperechoic   oval shaped mass in right lobe                                            Response to treatment                      Hypoechoic due to liquefaction of mass - Based on right hypochondriac and epigastric pain , fever * USG finding of hyperechoic mass in right lobe of liver along with other supportive investigations like leucocytosis ( suggestive of infection/inflammation) and ALP ( Alkaline phosphatase ) rise in LFT is a suggestive diagnosis of  LIVER ABCESS. Considering the following factors:  1) Age of the patient
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56F FEVER SECONDARY TO L GLUTEAL ABSCESS WITH AKI(PRERENAL) WITH CHOLELITHIASIS WITH GB SLUDGE WITH GRADE II FATTY LIVER WITH HEPATOMEGALY AIYH HTN SINCE 1 YEAR

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TEJASWINI MARISA(INTERN) This is online E log book to discuss our patient’s de-identified health data shared after taking   his/her/guardian’s signed informed consent. Here we discuss our individual patient’s problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problms with collective current best evidence based inputs. This e-log book also reflects my patient centered online learning portfolio and your valuable inputs on comment box is welcome . A 56 year old female came with c/o pain abdome since 10days C/o generalised weakness since yesterday morning(13/3/23) Hopi: Patient was apparently alright 10 days back then she had fever for 3 days which is low grade, intermittent, associated with chills and rigors  No h/o vomitings, loose stools On 3rd day of fever there is SOB which is insidious in onset decreased by lying down  No orthoponea No PND H/o decreased urine output for 1 day amd went to local hospital and
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