General Medicine Internal Assessment

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Chief complaints: A 78 year old male came with chief complaints of: - no passage of urine from morning  - swelling in the left hand and right leg  HOPI: Patient was apparently asymptomatic 1 month back when he started noticing swelling in the left ankle and gradually progressed covering the whole leg in 6 days.  He was taken to Suryapet Hospital where they referred to Gandhi Hospital but the patient's attender did not wanted to stay there so they took him to a private hospital.  Surgical dressing was done in view of Necrotizing fascites and patient was asked to review after 10 days. Dressing was done again and surgery was suggested.  - From today morning the patient is complaining of no urine output and swelling in the right leg and left hand. He went to some hospital where they kept Foley's catheter but it was not properly kept .  So patient came to our hospital with complain of Anuria since morning and swelling in the right leg ams left hand.  PAST H...
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70 YEAR OLD MALE WITH ALTERED SENSORIUM

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CHIEF COMPLAINTS : - complain of vomiting at 4:00 p. m on 29/09/22 - complain of BREATHLESSNESS since then  - complain of unresponsiveness @7:00 p. m on 28/09/22  HOPI : A 70 yeal old man was brought to the casuality with complaint of an episode of vomiting at 4:00 p.m on 28/09/22, which was non-projectile, non bilious, non blood stained with food particle as content.  - After which from 7:00 p. m he started getting breathlessness associated with which was not associated with chest pain, palpitation, PND, orthopnoeaorthopnoea.  - No history of fever / cough/ seizure like activity / cold / burning micturition / chest pain / abdominal pain / decreased urine output / head injury.  PAST HISTORY  - K/c/o HTN since 2 years and on treatment  - k/c/o Asthma since 3 years and on treatment  - no other comorbidities  PERSONAL HISTORY : Diet: mixed  Appetite: normal Bowel and bladder movement : regular  Allergies : to dust  Addiction : Alc...
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Intern Online assessment - General Medicine

    During Unit duty  Case 1 https://151arushikimari.blogspot.com/2022/09/chief-complaints-complain-of-vomiting.html My Orientation around this case : 1. What might be the reason of his breathlessness?  Ans. May be due to binge of alcohol intake 2. What are his precipitating factor for breathlessness?  Ans. - H/o asthma since 3yrs          - allergy to dust          - binge alcohol intake  3. What are his systemic examination finding?  Ans. In Respiratory system examination, B/L rhochi present in Infra-axillary area.  4. Why Inj. Thiamine is usually given to chronic alcoholic?  Ans. To prevent Thiamine induced Wernick's Encephalopathy.  Case 2 https://151arushikimari.blogspot.com/2022/08/57-year-old-male-with-pain-in-right.html My orientation around this case  : 1. What is the mechanism of development of AKI in patient with NSAID abuse?  Ans. Reduced renal blood flow due to decr...
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