FINAL MBBS PRACTICAL LONG CASE

​ 18 yr   old female patient came with c/o diffuse pain abdomen since 2 weeks  C/o    vomitings since 5 days  C/o    loose stools since 2 days  C/o Fever on and off since 1 week  HOPI: patient was apparently asymptomatic 2 weeks back then she had diffuse abdominal pain after eating hostel food (5 other people also had similar complaints ) treated conservatively  From 5 days pt had increased intensity of pain in the lower abdomen- colicky type , intermittent , not radiating to back, sudden in onset    pain not relieving on taking medication and associated with vomitings  Vomitings - since 5 days (15-20 episodes ) Non bilious , non projectile , food as content .  Loose stools from 2 days - watery in consistency , no blood in stools  Fever on and off since 1 week not associated with chills and rigors  Past history : not a k/c/o DM , HTN, Asthama , Epilepsy , TB , Thyroid .  O/E: pt is c/c/c  No signs ...

​ 34 YR OLD FEMALE WITH GENERALISED BODY PAINS Patient came to casuality with , c/o generalised body pains since 4 months  A/w pedal edema since 1month A/w fever  HOPI:  Patient was apparently asymptomatic 4 months back then she developed severe joint pains involving toes and fingers not a/w swelling slowly progressing to involve other joints , wrist, elbow, shoulder,knee, and ankle - pain a/w restriction of movement since 3 months - stiffness of joints present since 3 months , aggrevated with increased activity  -stiffness and pain are more in the morning ( after waking up ) and decreasing as the day progressed ( increased again at the night after 7.30pm ) disturbing her sleep quality  -swelling joints present at the knee and MCP joints since 4 days ( on and off) resolves spontaneously  -swelling at ankle : Non pitting type , increased when standing and working and decreased at rest - pt c/o decreased capacity to work due to pain since 4 months  -No s...

​ A 65 yr old male came to casuality with c/o diffuse chest pain and right sided abdominal     pain since yesterday morning 3am   C/0 vomitings since yesterday evening  HOPI: pt was apparently asymptomatic 4day ago then he had on and off right sided    abdominal pain gradually progressive not radiating to back not relieving on rest and pt also had 2 episodes    of vomiting non bilious , non projectile , food as content .  Associated with chest pain which was insidious in onset gradually progressive  Squeezing type of pain . He had similar complaints    1 year ago , treated conservatively . Pt was chronic alcoholic from 10years ,daily he consumes 90ml/day  Last intake of alcohol - 1 day ago  No H/0 of loose stools , fever , palpitations ,constipation ,burning micturition  Past history : not a k/c/o DM , HTN, Asthma, epilepsy, thyroid . O/E: Patient is conscious ,coherent and cooperative moderately built and modera...

​ A 70 year old female home maker since 10-15 years (farmer by occupation) came to causality in drowsy state. HOPI:  Patient was apparently asymptomatic 10 years back ,then patient had h/o fall for which she went to local hospital there she got diagnosed with DM and since then she is on OHA medication(glim m2).4 years back she had h/o fall and went to hospital and got diagnosed with HTN. 1 session of dialysis was done (indication/cause unknown ) .Patient wasn’t on any medication for HTN .1 month back she developed hypoglycaemia secondary to OHA’s ,then resolved later.Patient had h/o fall 4 days back ,fracture of IT femur right leg operated(? ORIF done).On POD 2, patient was drowsy ,opening eyes to deep pain .Since yesterday ,she is unable to recognise patient attenders. PAST HISTORY:  K/C/O  DM since 10 years & on medication. K/C/O HTN since 4 years GENERAL EXAMINATION:  O/E : Patient is responding to vocal commands Pallor - present Icterus  absent Cyanosis ...

  CBBLE  UDHC SIMILAR CASE STUDY         CBBLE  UDHC SIMILAR CASE STUDY A 75 year old male was brought to the casualty for further care for known case of CVA diagnosed 1 week back. HISTORY OF PRESENTING ILLNESS The patient was apparently asymptomatic 10 days back when he observed deviation of mouth. associated slurring of speech not associated with drooling of saliva.The patient also complained about throat pain and difficulty in swallowing(solids and liquids equally) 10 days back for which Upper GI endoscopy was done(which showed no abnormality). This lead to the patient's reduced appetite. The patient also complained of generalised weakness since 10 days. This was also associated with headache(diffuse) and approx. 12 episodes of vomitings lasting for 2-3 days 10 days back. The patient also complains of continuous hiccups since 3 days which gets intermittently relieved by itself. The patient is a k/c/o DM 2 and HTN which was diagnosed 10 years back wh...

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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.  I\"ve 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 clinical data including history, clinical findings, investigations and come up with a diagnosis and treatment plan.   CASE :  A 55year old male, toddy climber by occupation came with complaints of pain in abdomen and fever . FOLLOWING IS MY ANALYSIS OF THE PATIENT\"S PROBLEM : The problems in order of priority I found are : 1) Severe pain abdomen since 10 days 2) Fever since 7 days. 3) Decreased appetite since 7 days. ...