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BIMONTHLY INTERNAL ASSESSMENT

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  26 year old woman with complaints of altered sensorium somce 1 day,headache since 8 days,fever and vomitings since 4 days More here:  https://harikachindam7.blogspot.com/2020/12/26-year-old-female-with-complaints-of.html Case presentation  links:  https://youtu.be/fz9Jssoc-mA https://youtu.be/d4lLX04oL8 https://youtu.be/CSCxw2zp7Oc a). What is the problem representation of this patient and what is the anatomical localization for her current problem based on the clinical findings? problem: • headache 1 -2 times /week since 1 month and along with neck pain  • both hands small joint pain and later elbow and shoulder involved. she diagnosis as SLE •  she present to causality with altered sensorium and irrelavent talk  • history of vomittings and generalised weakness ,decreased appetite ,unable to walk  • history of low grade fever and joint pain  Anatomical location  : she has low grade fever,chronic headache along with neck pain and altered sensorium.....suggested may be problem in the 
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51 year old with chronic kidney disease on mhd

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  51 year old male came with complains of ulcer on left foot and right foot since 3 months.  Ulcer was insidious in onset and gradually progressive( initally a blister progressed to present size) non healing type.  He was a k/c/o diabetes and hypertension since 30 years for which he was taking medication.  He had a history of difficulty in micturition 10 years back for which he went to hospital and diagnosed with CKD and was on medication.  4 months back he developed bilateral pedal edema and started dialysis ( maintenance hemodialysis). 20 dialysis were done in kims, narketpally and 10 dialysis were done in suryapet.  He has habbit of drinking since 35 years( 90ml- quarter/ day) .  Not a k/c/o asthma, tuberculosis, vascular and cardiac disorders.  No past history of similar complaints No past history of hospitilization or surgery FAMILY HISTORY: No H/O Diabetes, Hypertension, Asthma, Epilepsy, Tuberculosis, CVA, CAD.  PERSONAL HISTORY: Diet :mixed Sleep :adequate  Bowel and bladder :r
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BIMONTHLY INTERNAL ASSESSMENT

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  1) A 55 year old man with Recurrent Focal Seizures Detailed patient case report here: http://ushaindurthi.blogspot.com/2020/11/55-year-old-male-with-complaints-of.html 1. What is the problem representation of this patient and what could be the anatomical site of lesion ? A.55 Y M patient who is a mestri worker came with c/o inability to move his right upper limb and episodes of seizures.He is a chronic alcoholic and beedi smoker since 35 years. Lesions may be seen in left fronto parietal temporal and occipital lobes.mostly temporal region. 2. Why are subcortical internal capsular infarcts more common that cortical infarcts? A. small subcortical infarcts (RSSIs) mostly result from the occlusion of a single, small, brain artery due to intrinsic cerebral small-vessel disease (CSVD). Some RSSIs may be attributable to other causes such as cardiac embolism or large-artery disease, and their association with coexisting CSVD and vascular risk factors may vary with morphological magnetic reso
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A 68 year old female prsented with diminision of vision since 6 months with denovo hypertension

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This is an online E log book to discuss our patient's d-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:  A 68 year old female presented to ophthalmology opd with complaints of diminished vision since 6 months,diagnosed with right eye SMC admitted for cataract surgery referred to medicine opd in view of high bp recordings Bp 220/120 mm of hg No ℅ Headache vomitings dizziness  neck pain is present occasionally  No pedal edema  shortness of breath on exertion present  palpitations absent She is using dexamethasone  and acyclofenac for body pains a
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