Posts

Bi monthly assessment March.

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  1. 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? 60 year old male chronic smoker & alcoholic non diabetic & non hypertensive c/o fever since 15 days associated with burning micturition, on & off facial puffiness , abdominal distention , SOB Grade -2 which progressed to Grade -4 , aphthous ulcers & dysphagia. O/E: Distended abdomen with dilated superficial abdominal veins Shifting dullness + Localization: Cirrhosis of liver with portal hypertension UTI AKI on CKD Specificity of dilated abdominal veins :98%, sensitivity 42% in diagnosing hepatocellular disease. 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 o...

45M with pain abdomen and vomitings with k/c/o DM & HTN.

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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. 45M presented to casuality with c/o Pain abdomen and vomitings since yesterday morning. Pt was apparently asymptomatic 10years back where he developed epigastric burning sensation followed by vomiting. Pain aggrevated after food intake and relieved with medication. On UGIE they were told that ?ulcer has began now and he should stop alcohol and tobacco chewing. Then 3 years back patient met with an accident (he was under alcohol influence) developed injuries and hosp...

Bimonthly..

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   Cishwanatham Bimonthly assessment February February 19, 2021   CASE 1 What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings? Problem representation 50 year man chronic alcoholic and tobbaco chewer with and previously with aggressive behaviour and history of GTCS 10years ago  History of fracture of left leg operated and was diagnosed to be diabetic 2 years ago, Now presented with the complaints of Frequently walking into objects along with frequent falls since, Drooping of eyelids(progressing as the day passes) and ,involuntary movements of hands  ,Talking to self since 1.5 years . previously aggressive and now not expressing emotions,and also thin urine stream since 1year,chronic hypokalemia, Anatomical location  Basal ganglia b) What is the etiology of the current problem and how would you as a member of the treating team arrive at a diagnosis? Please chart out t...

65 M with sudden onset chest pain.

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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 comments   A 65 old Retiered security guard and farmer presented with complaints of sudden onset chest pain since 6 hours associated with sweating. Patient was apparently normal 35 years back, later he had an penetrating injury to left eye, while he was cutting wood small piece of wood penetrated in his left eye following which he used some herbal medication (applied on eyes), end up in blurred vision. 30 years back he had a History of fall (from vehicle) following which he had Right eye inju...

Bimonthly assessment jan.

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1) 26 year old woman with complaints of altered sensorium somce 1 day,headache since 8 days,fever and vomitings since 4 days. a). What is the problem representation of this patient and what is the anatomical localization for her current problem based on the clinical findings? Problem representation: 26 year old Immunocompromised lady presents with Acute onset Altered sensorium and signs of meningism. Anatomical localisation: In the background of immunocompromised State , length and tempo of the presentation I would think acute aetiology like infections, drugs and toxins. With three years history of systematic lupus erythematosis where she was on methylprednisolone since three years leading to immuno suppression may flare up chances of infection. With detailed history the drugs which she was using like hydroxychloroquine , sulphasalazine,methylprednisolone, alandronic acid and gabapentin doesn’t explain her symptoms and on further probing the attenders at any point they refuse that she ...