General Medicine 2nd internal(14-07-2023) Answer sheet

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A 27yr old patient came with chief complaints of pedal Edema since 10 days

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  This is an online E log book to discuss our patient's de-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. CHIEF COMPLAINTS- C/o loss of appetite since 20 days C/o tremors since 15 days  C/o blood in urine since 10 days and C/o pedal edema since 10 days HISTORY OF PRESENT ILLNESS- Patient was apparently asymptomatic 20 days back then he had loss of appetite for which he went to the hospital and was diagnosed as CLD spleenomegaly and portal hypertension for which he  took medication after which he developed haematuria since 10 days and pedal Eden’s which is of pitting type.  Pedal edema
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  LEFT HEART FAILURE VS RIGHT HEART FAILURE- In heart failure, the heart can no longer pump enough blood around the body. The heart muscle is either too weak or not elastic enough. Left-sided heart failure : The left ventricle of the heart no longer pumps enough blood around the body. As a result, blood builds up in the pulmonary veins. This causes shortness of breath, trouble breathing or coughing – especially during physical activity. Left-sided heart failure is the most common type. Left sided heart failure occurs in people with-  Coronary artery disease Heart attack High blood pressure Valvular heart disease Abnormal heart rhythms  Diseases such as amyloidosis sarcoidosis Other risk factors include-  Diabetes Obesity Sleep apnea Smoking Toxins Right-sided heart failure : Here the right ventricle of the heart is too weak to pump enough blood to the lungs. This causes blood to build up in the veins (the blood vessels that carry blood from the organs and tissue back to the heart). The
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A 65 yr old female patient came with giddiness

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  This is an online E log book to discuss our patient's de-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. CHIEF COMPLAINTS- C/o loss of hearing since 3 months  C/o giddiness since 3 months  HOPI-  Patient was apparently asymptomatic 3 months ago. Then she developed giddiness of sudden onset, aggravated on lying down in supine position and changing positions from supine to standing or sitting position. Giddiness is not associated with nausea, vomiting, headache.  H/o nocturia present  H/o tingling sensations in the lower limbs H/o hearing loss since 3 months  No h/o  trauma to the head
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