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Showing posts from November, 2020

Bimonthly internal assessment October

    "57 year old man with jaundice, pedal edema and abdominal distension since three years and bleeding gums since three days" https://swathibogari158. blogspot.com/2020/09/chronic- decompensated-liver-disease. html 1) What is the reason for this patient's ascites?  Ans.  The cause for ascitis might be cirrhosis of liver because the patient is a chronic alcoholic since 40 years.  2) Why did the patient develop bipedal lymphedema? What was the reason for the recurrent blebs and ulcerations and cellulitis in his lower limbs?   Ans. Bilateral pedal oedema may be due to the decrease in the levels of albumin (long standing cirrhosis).  The ulcerations are due to limited movements (improper dressings).  3) What was the reason for his asterixis and constructional apraxia and what was done by the treating team to address that?   Ans. Asterixis is a clinical sign that describes the inability to maintain sustained posture with subsequent brief, shock like, involuntary movements. Th

Bimonthly internal assessment-November

 CASE : 1 1) 1) "55 year old male patient  came with the complaints of Chest pain since 3 days Abdominal distension since 3 days Abdominal pain since 3 days and decreased urine output since 3days and not passed stools since 3days. https://sreejaboga.blogspot.com/2020/11/is-online-e-log-book-to-discuss-our.html?m=1  A)W here are the different anatomical locations of the patient's problems and what are the different etiologic possibilities for them? Please chart out the sequence of events timeline between the manifestations of each of these problems and current outcomes.  ANATOMICAL LOCATIONS WITH ETIOLOGY: GIT (Pain abdomen) : Etiology: Pancreatitis secondary to ? chronic alcoholism KIDNEYS (Oliguria) : Etiology: AKI (pre renal due to fluid loss in pancreatitis) Sepsis induced ATN HEART / LUNGS (SOB) : Etiology: AKI leading to fluid overload and heart failure. Pancreatitis leading to pleural effusion / ?ARDS GIT (Constipation) : Etiology: ? paralytic ileus secondary to pancreat

A 48year old male with diabetic ketoacidosis 2° to alcohol(resolved)?OHA(non-compliance) 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. Here is a case i have seen :  48 yr old male came with cheif complaints Pain abdomen and shortness of breath since 3days Vomittings 4 times/day which lasted for 1 day  HOPI: PT was apparently asymptomatic 3 days back then he developed pain abdomen after his alcohol intake  Pain in Rt hypochondrium and epigastric region associated with vomittings    Vomiting is non bilious , non projectile , food as particle  Shortness of breath gradual in onset and it was progressivel

Chronic GE 2° to ?retroviral disease with severe anemia under evaluation(bicytopenia) with hypoalbuminemia

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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. Here is a case i have seen :  60 year old female came with c/o fever since 20 days Vomitings since 20 days Burning type of pain in the epigastrium since 20 days Decreased appetite since 20days. HOPI: She was apparently asymptomatic 20 days back then developed fever which was insidious in onset,gradually progressive associated with chills and rigors subsided with medication Vomitings since 20 days,non projectile, bilious,food particles as content  Burning type of pain