online blended bimonthly assignement for month of may 2021

  74 YEARS OLD FEMALE CAME TO THE CASUALTY WITH ALTERED SENSORIUM SINCE MORning A 74 year old woman presented to the casualty In altered sensorium since morning 10am (4/10/21) She is an elderly woman, who studied till her 4th grade and has 6 children, 4 sons and 2 daughters. Her husband expired in 1982, according to her son the reason for his father's death  is not clearly known and it was suspected to be due to suicide because of family issues.   30 years back she underwent hysterectomy- secondary to ?fibroids  25 years back on routine check up she was diagnosed to be a Hypertension and diabetic.  She was started on Tab metxl 50mg along with Tab Galvusmet 50/500mg (vildagliptin along with metformin)  10 years back she consulted a local doctor for bilateral lower limb edema and was diagnosed with hypothyroid and was started on Tab thyronorm 100mcg which was later made to 50mcg. 6 years back she experienced chest pain along with dyspnea at rest after wh...

  This is an 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 patient's clinical problems with collective current best evidence based inputs.This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment"   A 18yr old male Fever with thrombocytopenia I've been given this case to solve in an attempt to understand the topic of "Patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan.        A 18 yr old male came to the OPD with chief complaints of   -fever since 2 days - vomiting’s since 2 days -diarrhea ...

  It was a wonderful learning experience from all the cases we have seen online. Due the efforts of our general medicine department , it is making a a lot of help to connect to subject as well as patients nd not waste our time

 1.what could be the cause for his SOB Ans- His sob was is due to Acidosis which was caused by Diuretics 2. Reason for Intermittent Episodes of drowsiness  Ans-Hyponatremia was the cause for his drowsiness  3.why did he complaint of fleshy mass like passage inurine Ans-plenty of pus cells in his urine passage  appeared as  fleshy mass like passage to him 4. What are the complicat ions of TURP that he may have had Ans-         Difficulty micturition         Electrolyte imbalances          Infection

 A1.   Evolution of symptomatolgy: 8yrs back- diagnosed with DM 3 days back- developed chest pain radiating to back and dragging type since morning - giddiness and profuse sweating. Anatomical localization in this pt. is heart primary etiology is uncontrolled DM nd inferior wall MI A2. TAB. ASPIRIN 325 mg PO/STAT TAB ATORVAS 80mg PO/STAT TAB CLOPIBB 300mg PO/STAT INJ HAI 6U/IV STAT A3. starting PTCA after 12 hours is acceptable but after 3 days is not correct and can lead to complications.

 A1. Evolution of symptomatology : 12yrs ago- diagnosied with DM. 1yr ago  - has heartburn like symptoms which are relieved without medication 7months ago- diagnosed with TB nd took treatment 6months ago- diagnosed with HTN  1/2 hour back- SOB grade 4 Anatomical localization in this patient is Heart. primary etiology is partial bloakage in coronary artery. A2. INDICATIONS: Acute ST-elevation myocardial infarction (STEMI) Non–ST-elevation acute coronary syndrome (NSTE-ACS) Unstable angina. Stable angina. Anginal equivalent (eg, dyspnea, arrhythmia, or dizziness or syncope) High risk stress test findings.          CONTRAINDICATIONS : Intolerance for oral antiplatelets long-term. Absence of cardiac surgery backup. Hypercoagulable state. High-grade chronic kidney disease. Chronic total occlusion of SVG. An artery with a diameter of <1.5 mm. A3. when PCI is  performed in pt. who does not need it ..it lead to complications. Harms of over treatme...

 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...