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BIMONTHLY ASSESSMENT MARCH 2021

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bimonthly examination - march March 21, 2021 1) Please go through the patient data in the links below and answer the following questions: https://ashakiran923.blogspot.com/2021/03/60-years-old-male-fever-under-evaluation.html?m=1 a). What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings?How specific is his dilated superficial Abdominal vein in making diagnosis? Based on the clinical symptoms and signs, the clinical diagnosis of the patient can be-  UTI with cirrhosis of liver with portal hypertension.  b) What is the etiology of the current problem and how would you as a member of the treating team arrive at a diagnosis? What is the cause of his hypoalbuminemia?Why is the SAAG low?                 The etiology of the disease in this patient could be a chronic history of alcoholism. Chronic smoking leading to his apthous ulcers.  Based on his clinical finding there could be portal hypertension wh
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19 yrs old female with Acute Gastroentritis with Viral pyrexia

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C/o of fever since 1 days a/w chills and relieved on medication  vomitings since 1 day 3 episodes, non projectile and non bilious cough since 1 day , non productive  No H/o sob,pedal edema, loose stools, pain abdomen  past History  not a k/c/o HTN , DM,ASTHMA,CAD,CVA G o/E pt is conscious, coherent, cooperative  no signs pallor, icterus, cynosis clubbing lymphedenopathy, kilonycia  system Examination  R/s_ BAE+ CVS -s1,s2 + p/A -soft,non tender,not rigid,  CNA-NAD Treatment  oN the day of admission  1.IVF 1 unit with 1 amp optineuron @50 ml /hr 2.ors sachets  3.Tab PCM 650 mg po/tid 4.Inj ZOFER 4mg iv/tid 5.syp ASCORIL D 10 ml po/tid 6.TAB ZINCOVIT PO/OD 7.TAB PAN 40 MG PO/OD day 1 1.Tab AZITHROMYCINE 500 MG PO/OD 2.ors sachets  3.Tab PCM 650 mg PO/TID 4.TAB ZOFER 4MG PO/OD 5.syp ASCORIL D 10 ml po/tid 6.TAB ZINCOVIT PO/OD 7.TAB PAN 40 MG PO/OD DAY 2. 1.Tab AZITHROMYCINE 500 MG PO/OD 2.ors sachets  3.Tab PCM 650 mg PO/TID 4.TAB ZOFER 4MG PO/OD 5.syp ASCORIL D 10
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50 yrs old with HFrEF with DCMP secondary to ischemic heart disease

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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 box is welcome. Team: Interns- M Supriya Mohitha K Sowmya Sanjay Amrutha Dr.Druga Krishna PGY1 Dr.Ajith Kumar PGY2 Dr.Laxma Reddy PGY3 Dr.Manasa PGY3 Dr.Vijaya Lakshmi (Ast.Prof.) 50 years old male presented on 4/3/21 to GM OPD with  C/o pedal edema from 10 days C/o SOB from 10 days C/o decreased urine output from 10 days C/o abdominal distension from 10 days Patient was apparently asymptomatic 10 days back then he developed pedal edema which is extending upto knee,acute in onset, grad
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54 yr old male with Left upper lobe pneumonia secondary to Koch's

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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 box is welcome. Team: Interns- M Supriya Mohitha K Sowmya Sanjay Amrutha Dr.Druga Krishna PGY1 Dr.Ajith Kumar PGY2 Dr.Laxma Reddy PGY3 Dr.Manasa PGY3 Dr.Vijaya Lakshmi (Ast.Prof.) 54yr old male  present with  C/o chest pain since 10 days  C/o SOB since 10 days  C/o cough with expectoration since 10 days pt was apparently asymptomatic 10days back then developed chest pain on Left side which is pricking type ,sudden in onset ,non radiating aggravated on exertion a/w  SOB  which is grade
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54 yr old male pt with status epilepticus,Hypokalemia,hypoproteinemia,diabeties with microvascular complications

54 yr old male pt came with Complaints of fever from 6 days Complaints of seizure from  yesterday Patient was apparently asymptomatic 6 days back then he developed a fever for 2 days which was low grade ,intermittent and associated with chills and relieved on medication, patient was normal up to 2 days till Monday night then he developed involuntary movements of upper and lower limb and associated with tongue bite . patient was taken to private hospital [up To 8 episodes] of seizures happened till next day morning, then patient was taken to government hospital where  CT was done then he had 5 more episodes of seizures within 2 days and was referred to KIMS for the furture evaluation K/c/o DM since 15 yrs and on TAB.METFORMIN 500MG and TAB GLIMIPIRIDE K/c/o HTN since 3 yrs and on medication TAB.ATENOLOL 50MG Alcohol occasionally somker [stopped 20yrs back] O/E pt is conscious coherent cooperative  Temp-afebril PR-79bpm BP-130/90 mmHg spo2-97%at room air GRBS-335 mg/dl Syst
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46 yr old male with HFrEF with type 4 cardi renal symdrom with DCMP with ischemic Hepatits

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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 box is welcome. Team: Interns- M Supriya Mohitha K Sowmya Sanjay Amrutha Dr.Druga Krishna PGY1 Dr.Ajith Kumar PGY2 Dr.Laxma Reddy PGY3 Dr.Manasa PGY3 Dr.Vijaya Lakshmi (Ast.Prof.) 46 years old old male patient came with  c/o abdominal distension since 20 days   c/o shortness of breath since 20 days and c/o  pedal edema since 20  days Patient was apparently asymptomatic 6 years back then had  throne pricking on the left foot followed which he developed swelling of the left foot for wh
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50 yrs old male k/c/o HbsAg +ve with cirrhosis

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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 box is welcome. Team: Interns- M Supriya Mohitha K Sowmya Sanjay Amrutha Dr.Druga Krishna PGY1 Dr.Ajith Kumar PGY2 Dr.Laxma Reddy PGY3 Dr.Manasa PGY3 Dr.Vijaya Lakshmi (Ast.Prof.) A 50 year old male came with c/o distention of abdomen since 7 months,B/L pedal edema since 7 months,  pt was apparently asymptomatic 7 months back then he developed  low grade fever with yellowish discolouration of eyes followed by pedal edema  which is gradually progressive and pitting type -no aggrevating
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