general medicine internals

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heart failure case

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A 44 year old male patient it came to casualty with  C/o shortness of breath (grade II) according to NYHA classification Not associated with orthopnea/PND. C/o B/L PEDAL EDEMA ( pitting type ) since 1 week  C/o decreased URINE OUTPUT since 1 week C/o FACIAL PUFFINESS since 1 week  Pt was apparently asymptomatic 1 week back then developed fever associated with chills and rigor, was diagnosed with typhoid and was treated outside in a private hospital  Pt also C/o loss of appetite, and 2 episodes of vomiting ( non bilious , non projectile ) not A/W nausea. Pt is a K/C/O  -CKD since 10 years on regular medication  - DM since 4-5 years  (on GLIMI M2 and GLIMI M1) -HTN since 1 year - on Tab TELMA-AM NO SIGNIFICANT FAMILY HISTORY PERSONAL HISTORY O/E- Pt is c/c/c obese  TEMP+98.4°F BP-130/80MMHG PR-89 BPM RR- 20CPM SPO2-98% @ RA CVS-S1S2 HEARD NO MURMUR RS-NVBS + NO CRYPTS P/A-SOFT, NON TENDER CNS-HMF INTACT APEX BEAT- 6TH ICS LATERAL AND OUTWARD JVP-RAI...
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general medicine may assignment

General medicine assignment for may  30/5/2021 Name:  Palle Lokesh Reddy Roll no:103 I have been given the following cases to solve in an  attmept 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 diagnosis and coem up with a treatment plan. This is the link of the questions asked regarding the cases:http://medicinedepartment.blogspot.com/021/05/online-blended-bimonthly-assignment.html Below are my answers to the Medicine Assignment based on my comprehension of the case  Pulmonology  A) Link to patient details: https:// soumyanadella128eloggm. blogspot.com/2021/05/a-55- year-old-female-with- shortness-of.html Questions: 1) What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patient's problem?...
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CKD

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A 65yr old male patient who is a resident of nakrekal and farmer by occupation came to the OPD with the chief complaints of   Urinary retention since 2 days Abdominal distention since 2 days Fever since 3 days HISTORY OF PRESENT ILLNESS: PAST HISTORY He had right sided indirect inguinal hernia for which hernioraphy was done 13 years back. He is known case hypertension since 4 years and he is on medication since 4 years No history of diabetes,asthma,tb,cad,stroke  PERSONAL HISTORY married Diet:mixed Appetite:normal Sleep:adequate Bowel and bladder:urinary retention Addictions:regular alcoholic FAMILY HISTORY: family member has hypertension  No history of diabetes,asthma,tb,cad,stroke. GENERAL EXAMINATION Patient is concious,coherent,cooperative,moderately built and moderately nourished VITALS: Temperature:98.7°F Pulse rate:82b/m Respiratory rate:22c/m BP:140/70mmhg Spo2:99 Grbs:134mg% Pallor: present Icterus:no Clubbing:no Cyanosis:no Lymphadenopath...
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