Days in medicine posting

A 20yr male presented to our opd with oocomplaints of - high grade fever since 1ooweek associated with vomiting 3episodes /day,bilious vomiting since 2days  on empty stomach,food contents as particles when he eats . -body pains since 3days aggrevated on sleeping relieved on walking -h/o malena since 2days -he was apparently asymptomatic 2months back,later he developed palpitations, shortness of breath, dizziness and headache for which he went to cardiologist at nalgonda and was told that he had irregular heart rate for which he was prescribed few medications and symptoms relieved.Now he developed fever since 7days which is high grade, intermittent type associated with vomiting of 2-3ep/dayand loose stools with foul smelling and mucus but no blood in stool. PAST HISTORY:  K/c/o BPPV  -He is not a k/c/o DM,HTN, seizures,asthma PERSONAL HISTORY:  he is a degree final yr student,his diet was mixed, decreased appetite, constipation since 3yrs normal micturition,non alcoholic and non smoker

 1)Anatomical diagnosis -? Glomerulosclerosis                                                                        Etiological diagnosis -  ?? Nephrotic syndrome secondary to the diabetic nephropathy or CKD.      2)Reasons for I) Azotemia : impaired renal excretion of urea and creatinine secondary to CKD.  II) Anemia : decreased erythropoietin.  III) Hypoalbunemia: capillary basement membrane and podocytes damage.  IV)  acidosis: acidification of urine is lost.                                       3) Rationale : syp potchlor was given because of the hypokalemia.. Inj. NaHCO3 was given because of metabolic acidosis ..Insulin and antihypertensives are given because known case of DM and HTN. Orofer XT was given because of anemia.. Inj. Lasix was given to decrease her volume overload. Spironolactone was given it was a potassium sparing diuretic.Calcium was given to the patient  because of hypocalcemia secondary to CKD. Indications of NaHCO3:metabolic acidosis in cardiac arrest, Tricycli

A 48 year old Male patient , a farmer by occupation presented to opd  with  C/o :  fever since one week  Pain abdomen since one week associate with loose stools . Yellowish discoloration of eyes since one week Pedal edema since 5 days  Decreased urine output since 5 days c hematuria 4 days back HOPI : Patient was apparently asymptomatic one week back then he presented with c/o  Fever since one week,  high grade fever , continuous , not associated with child and rigors .associated with pain  abdomen..all over the abdomen , more in rt hypochondrium  .. h/o  : loose stools 5 episodes within 24hrs ,. 4 days  back  And h/ o : yellowish discoloration  of sclera skin and mucous membranes since one week   c/o b/l pedal edema since 5 days , from ankle to knee .. pitting type ..associated with burning micturation ,, and decreased urine output since 5 days  And hematuria 4 days back after receiving treatment in a local hospital in suryapet. patient then went to osmania  general hospital and got

Hello everyone.. I am sreeram , an intern posted in medicine department and one of the important terms of getting the internship completion is to complete my log book with my online log of what I learn during the course of my duties. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centred online learning portfolio and your valuable inputs on the comment box is welcome. A 20 year old man presented with a 5 day history of pedal edema. The youngest of 4 boys, he was apparently asymptomatic 5months back then  he first reported feeling unusual palpitations while lifting a 20L water can onto his bike, a Bajaj Pulsar 150cc. He reports that he had been having such palpitations with exertion even earlier but he could remember only as far back as this event. He reported those

  Hello everyone.. I am sreeram , an intern posted in medicine department and one of the important terms of getting the internship completion is to complete my log book with my online log of what I learn during the course of my duties. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centred online learning portfolio and your valuable inputs on the comment box is welcome. A 45yr old man , mirchi bajji shop owner by occupation hailing from miryalaguda had complaints of generalised body pains since 1week , which was shooting type and radiating all over back and neck pains . Pt also was complaining of bilateral feet and hands tingling . Then he went to a near by RMP where he got treated with Inj. Voveron but his symptoms had not got resolved.  Then the pt. Consulted anot