Name : A Shishira Reddy
Online learning portfolio link : https://02shishirareddy.blogspot.com/
Case 1
65 year old female with c/o fever since 20 days, b/l pedal edema since 20 days , sob since 3 days
Questions:
1)What is the provisional diagnosis?
Ans- ATYPICAL PNEUMONIA 2° ? CAP, ?HAP LEGIONELLA
TYPE 2 DM SINCE 10 YEARS ,HTN SINCE 10 YEARS
2)What are the features of CAP and HAP?
3)What are the causes for the spike of serum lactate?
Ans- Anaerobic metabolism, diabetic ketoacidosis, thiamine deficiency, malignancy, drugs/toxins like alcohol, cyanide, carbon monoxide, burns , regional tissue ischemia.
4)What is the cause for diarrhoea in the patient?
Ans- Her stool sample was collected and sent for microscope - strongyloides was confirmed.
It maybe due the roundworm or it maybe due to drug induced.
Discussion: A decreasing trend observed in the hemoglobin . Possibly hospital acquired anemia ?
CASE 2
21 YEAR OLD MALE CAME WITH CHIEF COMPLAINTS OF ALTERED SENSORIUM
1)What is provisional diagnosis?
Ans.Meningeal encephalitis 2°? Rickettsial fever ? TTP / HUS with AKI (resolved)
2)What is TTP ?Evidence supporting the differential TTP.
CASE 3
80 YEAR OLD MALE PATIENT CAME IN UNRESPONSIVE STATE.
1)What is the cause for unresponsiveness ?
Ans-The patient presented in unresponsive state, with grbs of 40mg/dl. The probable cause is hypoglycemia. Later he started to hyperventilate , which was because of acidosis.
2)What is the provisional diagnosis?
Ans-Recurrent hypoglycemia (resolved) with PTB.
Clinico-radilogically diagnosed.
Reference from bartsandthelondonnhs.uk
CASE 4
70 YEAR OLD MALE PATIENT ,
1)What is the probable cause of anemia ?
Ans.Bleeding per rectum
2)Cause for bleeding per rectum?
And. Haemorrhoids -
After surgery refferal, he was diagnosed to have haemorrhoids of grade 4 , with rectal prolapse.
Glycerine dressing was done , he was advised sitz bath, and anobliss ointment.
He had two PRBC transfusion, which was done to perform colonoscopy to rule out any tumor .
Work up : monitoring the vitals during blood transfusion
Glycerine dressing for grade 4 haemorrhoids.
CASE -5
A 47 year old female presented with chief complaints of SOB, generalized swelling of body, cough
-What is the provisional diagnosis?
-Detail of her ANA profile ?
-What is the criteria for SLE ? Is the patient's features fitting into the criteria?
Discussion
Can SAAG of 1.06 always be taken as portal hypertension?
Comment on nailfold capillaryscope
What is mizutani sign ?
PROCEDURES:
Ascitic tap on 20 year/F under the guidance of DR. Aditya smitinjay(SR)
-Foleys catheterization of 20 year /F under guidance of Dr .Manikarao Vinay
-Ryles tube - under guidance of Dr. Pavani
-Ascitic tap on 45 year old male under guidance of Dr. Bharat, Dr. Kranti
-Assisted central line - DR . Nishitha, Dr. Venkat sai
ICU/AMC duty : -- Ascitic tap on 45year old male
--assisted in intubation (suction )
--CPR for a 35 year old male.
NEPHROLOGY -
assisted in central line - suturing under guidance of Dr.Nishitha , Dr.Venkat Sai.
PSYCHIATRY:
Cases seen -
cannabis induced psychosis
Anxiety
panic disorder.
Ward - updated soap notes . Follow up on patients shifted to ward.
