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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sepsis secondary to right lower limb cellulitis

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A CASE OF 60 YEAR OLD WITH FEVER AND SOB AND LEFT LL SWELLING since 3 days A came to casuality with c/o fever since 3 days  SOB grade  since 2 days  LL swelling and redness since 1 day. Patient was apparently asymptomatic 3 days back and then he developed fever which was low grade, intermittent, relieved ontaking medication and not associated with chills and rigor. He has SOB, No orthopnea or PND or pedal edema or chest pain or palpitations. He applied ointment for leg pain over right foot and later he developed redness and swelling over right foot and with these complaints they went to outside hospital and on presentation to the outside hospital vitals spO2-74% on RA with BP 70/40. He was put on CPAP and inotrope support and reffered to our hospital General Examination: Patient is C/C/C No pallor, icterus, cyanosis, clubbing, koilonychia, lymphadenopathy, edema Vitals: Temp - 100 F PR- 104 bpm BP- 100/70mmHg RR- 28 cpm SpO2- 97% at RA CVS: S1 S2 + Limb examination: ...
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