GM internal assessment exam 14-07-2023

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  60 Year Old Female with CKD on Maintenance Haemodialysis...... December 05, 2023 This is an online E - log book to discuss our patients 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 portfolio and your valuable inputs on the comment box. December 05,2023 I have 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 60 year old female resident of suryapet farmer by occupation came to the OPD with CHIEF COMPLAINTS : Swelling of both le
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OSCE and learning points

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Symptoms of  Right and Left heart failure:- Preload and Afterload: Preload : Preload is volume of blood received by the heart. Basically preload is stretch.It is the ventricular stretch at the end of diastole. Occurrence : during diastole Depends on : The amount of ventricular filling. Preload is a volume. Affecting factors : venous blood pressure and the rate of  venous return.  Afterload :  Afterload is the pressure that the Chambers of the heart must generate in order to eject blood out of heart. Occurrence : during systole Depends on : The arterial blood pressure and vascular tone. Afterload is a pressure. Affecting factors : systemic vascular resistance and pulmonary vascular resistance  Pathophysiology:- LEARNING POINTS:- :- I have learnt how important is to take delailed history  :- I have learnt how important is the daily routine and occupation of the patient :- How essential it is to build communication with the patient and patient attender to gain thei
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45 years old female with shortness of breath

Chief complaints :  Fever since 10 days Giddiness since 3 days Dry cough since 3 days Loose stools since 1 day Vomiting since 1 day History of present illness : Patient was apparently asymptomatic since 10 days and then she developed fever which is associated with the chills and rigor and with diurnal variation increased during night and subsided by night and she had giddiness and shortness of breath since 3 days and then for which she went RMP doctor and he gave ORS and from then she had 1 episode of vomiting non projectile non bilious contains food particles and she had 1 episode of loose stools since 1 day and she has history of dry cough since 3 days . History of past illness :  She is not known case of diabetes, hypertension, epilepsy,CVA,CAD, thyroid disorders. PROVISONAL DIAGNOSIS :  Acute pulmonary Koch  S  Dry cough  Stool passed +  No Fever spikes  Decreased tingling sensation of wrists  O  Pt is conscious ,coherent , cooperative Temp:  BP: 100/70 mmHg  PR : 72 bpm  RR :  24c
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