internal assessment-II Paper -2



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CARDIOLOGY(C)

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 A1.   Evolution of symptomatology and event timeline -  Past- 10yrs ago - Operation for Hernia Since 2-3 yrs - Facial puffiness 1 yr ago - SOB grade II 1 yr ago - was diagnosed with Hypertension. When the patient came to OPD -  Since 2 days - SOB which progressed from Grade II to Grade IV. Since 2 days - Decreased urine output. Since 1 day - Anuria After admission -  CT scan - Showed dilated pulmonary vessels and thrombi in the atria. 2D Echo - Showed LV dysfunction. Anatomical location - Atria (SA node) A2. Digoxin - It is a cardiac glycoside              MOA - It increases intracellular sodium that will cause an influx of calcium in the heart and cause an                     increase in contractility. It is vagomimetic.               Indications - Heart failure and arrhythmias.           Carvediol - It...
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NEUROLOGY(E)

 Questions: 1) What could have been the reason for this patient to develop ataxia in the past 1 year? The patient has minor unattended head injuries in the past 1 yr. According to the CT scan, the patient has cerebral haemorrhage in the frontal lobe causing probably for the occurrence of Frontal love ataxia 2) What was the reason for his IC bleed? Does Alcoholism contribute to bleeding diatheses ? The patient has minor unattended head injuries. During the course of time the minor hemorrhages if present should have been cured on their own. But the patient is a chronic alcoholic. This might have hindered the process of healing or might have stopped the healing rendering it to grow further more into 13 mm sized hemorrhages occupying Frontal Parietal and Temporal lobes
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NEUROLOGY(B)

  1)      What is the evolution of the symptomology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patients problem? ANS. Timeline of the patient is as follows- 7 days back- Patient gave a history of giddiness that started around 7 in the morning; subsided upon taking rest; associated with one episode of vomiting 4 days back- Patient consumed alcohol; He developed giddiness that was sudden onset, continuous and gradually progressive. It increased on standing and while walking. H/O postural instability- falls while walking Associated with bilateral hearing loss, aural fullness, presence of tinnitus Associated vomiting- 2-3 episodes per day, non projectile, non bilious without food particles Present day of admission- Slurring of speech, deviation of mouth that got resolved the same day Anatomical location- There is a presence of an infarct in the in...
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