GENERAL MEDICINE 1st internal answer sheet

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40 year old with vomitings

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This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. 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 problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. Ihave been given this case to solve in an attempt 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 come up with diagnosis and treatment plan. A 40 years male, resident of chityala, field assistant by occupation came to the opd with chief complaints of vomitings 2 days back History of presenting illness: Patient was apparently asymptomatic 2 days back ...
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OSCE

How do you treat recurrrent non healing ulcers in Diabetes? Recalcitrant non-healing ulcers are inevitable and detrimental to the lower limb and are a major cause of non-traumatic lower limb amputations. Application of autologous Platelet Rich Plasma (PRP) has been a major breakthrough for the treatment of non-healing and diabetic foot ulcers, as it is an easy and cost-effective method, and provides the necessary growth factors that enhance tissue healing. PRP is a conglomeration of thrombocytes, cytokines and various growth factors which are secreted by α-granules of platelets that augment the rate of natural healing process with decrease in time. What might be the cause of vomitings in a patient of Diabetes? Factors related to your diabetes may cause you to experience nausea. Medication: Metformin is one of the more common medications used to treat diabetes. Nausea is a potential side effect for people taking this medication. Taking metformin on an empty stomach may make nausea worse...
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A 90 Year Old Female with chief complaints of bilateral pedal edema since since 10 days.

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 CHEIF COMPLAINTS  Fever since 10 days  Decreased apettite since 10days  B/L Pedal Edema  Decreased urinary output since one week Vomitings 5 days back. Chest pain 1 day back. HISTORY OF PRESENTING ILLNESS  Patient was apparently asymptomatic 10 days back then she had c/o B/L Pedal Edema pitting type ,c/o fever ,chills intermittent,and no evening rise in temperature.she also had c/o decreased urine output and decreased apettite since 10 days .she has complaints of vomitings 3 episodes 5 days back,which was non-bilious,non-projectile,containing food particles resolved after taking medications. PAST HISTORY:  K/C/O HTN-since 2 yrs  No H/O DM,TB  TREATMENT HISTORY: T.Atenolol 50 mg  T.Amlodipine 5 mg  No surgical history PERSONAL HISTORY : Appetite: decreased Non vegetarian Sleep : adequate No addictions FAMILY HISTORY: -No significance PHYSICAL EXAMINATION: GENERAL EXAMINATION : .pallor .no icterus,cyanosis,clubbing, lymphadenopathy. ...
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