Exam

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 is welcome." Chief compliants :   1) Pedel edema since 45 days  2) Shortness of breath since 5 days  3) Decreased appetite since 45 days  History of present illness:  50 year old male, father of 3 children , stone cutter by occupation.His routine is to get up in the morning and used to go the work by 9am and come back to home by 6pm.He likes spicy nonveg foods ,used to eat atleast 4times a week. 3 years back , patient stopped his occupation and started panipuri shop as his fri

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 is welcome." Complaints:  1) Pedal edema since 8 months  2) Decreased urine output since 8 months 3) Shortness of breath since 8 months. History of present illness:  Patient was daily labour by occupation and at 25years of age had her 1st pregnancy . patient had delayed labour for which C section was done.( Baby weight was 2kg) At 30 years of age , patient had second pregnancy and C section was done and Baby weight was 4 kg.patient had delayed healing of the sutures. At 31 yea

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 is welcome." Complaints:  Patient was on maintaining hemodialysis in outside hospital and want to continue hemodialysis in kims institute , so referred here. History of present illness :  Patient was student in osmania university,LLB student and also used to prepare for competitive examination and  apparently asymptomatic at 17 years of age , patient had weakness of the both lower limbs , visited multiple hospitals ,but it was not cured and patient was suggested to use ayurved

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 is welcome." Complaints:  1) Shortness of breath since 15 days  2) Decreased urine output since 15 days  3) cough with sputum since 4-5 days  4) Low back ache since 1 year . History of present illness :  Patient is shepherd by occupation and also used to do farming and apparently asymptomatic 10 years ago and then developed diminished vision in the right eye ,where he was diagnosed with cataract and got operated. 10 years back, post surgery ,patient stopped smoking and alcohol

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 is welcome." Complaints:  1) Pedal edema since 2 years  2) Decreased urine output since 1 month 3) Shortness of breath since 1 month 4) Burning micturition since 1 month. History of present illness :  Patient was farmer by occupation, developed decreased hearing sensation 15years back,  in the both ears along with discharge and consulted ent , he was advised surgery but the patient refused and continued his work.  10years back, Patient had Generalized weakness and body  pains

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 is welcome." Chief complaints :  Pedal edema since 20 days  Decreased urine output since 20 days  Shortness of breath since 20 days  History of present illness : IN 2012  • Patient had similar complaints for which he went to NIMS , there he was diagnosed with Hypertension and on  medications (? unknown )  and symptomatic treatment by which symptoms are subsided . IN 2013  • Patient had an episode of Hemoptysis and anuria for which he was taken to NIMS Hospitals , and USG showe

Elog links to my cases :  1) https://siddamsushmitharollno147.blogspot.com/2021/12/45-year-male-with-shortness-of-breath.html 2) https://harshitakusuma216.blogspot.com/2021/10/a-case-of-50yr-old-female-patient-with.html 3)  https://harikrishnarollno55.blogspot.com/2021/11/55-yr-old-male-with-polycystic-kidney.html?m=1 4)  http://muskaanmenghwani.blogspot.com/2022/01/a-50-year-old-male-with-loss-of-appetite.html  5) http://viharreddy127.blogspot.com/2021/12/ckd-ward-21221-update.html  6)  http://shubhasri98.blogspot.com/2022/01/48-yr-old-patient-ckd.html   7)  https://srakeshkumarrollno153.blogspot.com/2021/12/53-year-old-female-patient.html?m=1  8)  https://elogformedicalcasebyintern.blogspot.com/2021/12/28m-with-uremic-seizures-with-ckd-on-mhd.html  9) http://93harika.blogspot.com/2021/12/ckd-ward-38yr-old-male.html  10) https://vamsikrishna1996.blogspot.com/2020/12/supraja-medicine-elog-nephrology-case.html  11) http://nehapurohit115.blogspot.com/2022/01/general-medicine-case-discuss

SYSTEMIC EXAMINATION  RESPIRATORY SYSTEM  INSPECTION  • Chest is elliptical , bilaterally symmetrical shape. • Trachea is in central  • Movements are decreased ( Rt > lft )  • JVP - Normal  • No visible scars and sinuses . PALPATION  • All the inspectory findings are confirmed ,  • Trachea is in centre  • Movements  are decreased ( Rt > lft )  • Apex beat felt in Left 6 th ICS , 1 inch lateral to the midclavicular line  • Vocal fremitus decreased in all areas of left side PURCUSSION  • Dull note heard in all areas of left side  • Resonant heard in all other areas  AUSCULTATION  • Decreased air entry feom left side  • Normal vesicular breath sounds +  • Breath sounds decreased in  all auscultatory areas on left side . CARDIOVASCULAR SYSTEM  INSPECTION  • Chest is Elliptical and bilaterally Symmetrical • Trachea - Centre  • JVP - Normal  • Transverse diameter > Anterio posterior diameter. • No scars and sinuses  PALPATION  • All the inspectory findings are confirmed ,  • Trachea