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Bimonthly internal assessment

 CASE 1: 55 year old male patient came with the complaints of  Chest pain since 3 days Abdominal distension since 3 days Abdominal pain since 3 days and decreased urine output since 3days and not passed stools since 3days  https://sreejaboga.blogspot.com/2020/11/is-online-e-log-book-to-discuss-our.html?m=1 1.Anatomical locations and etiological possibilities: A.Pancreas:acute severe pancreatitis secondary to gall stones B.Kidney:Acute kidney injury secondary to pancreatitis C.lungs:Right pleural effusion secondary to acute severe pancreatitis Pleuropulmonary abnormalities are commonly associated with pancreatitis, respiratory dysfunction is rarely seen at the time of presentation to Emergency department (ED) but usually develops after fluid resuscitation. It manifests as acute lung injury or acute respiratory distress syndrome. It is one of the major components of multiple organ system dysfunction syndromes. Other manifestations are bilateral infiltrates, pleural effusion, pulmonary h
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60 yr old male with cor Pulmonale and chronic renal failure

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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. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. A 60yr old male pt , farmer by occupation came to the op with c/o intermittent cough with sputum since 6months c/o Abdominal distension since 20days c/o bilateral swelling of lower limbs since 15days c/o shortness of breath since 15days c/o indigestion since 15days Pt was apparently asymptomatic 6months ago, then he developed cough with sputum, intermittent in nature ,sputum small in quantity, non foul smelling , non blood tinged, associated with wheeze at night time. c
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Bimonthly internal assessment

Case 1: Q1 What is the  Reason for this patients ascites ?       The most common cause of Ascites is        Cirrhosis of liver        risk factors in this patient :       1. Chronic alcoholism since 40 years       2. Truncal obesity leading to metabolic syndrome causing NAFLD leading to cirrhosis           https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6092576/ Altered echo texture of liver due to Cirrhosis causes portal hypertension leading to increased hydrostatic pressure causing fluid accumulation hence Ascites  Q2  Bilateral pedal oedema which is of pitting type is due to decrease in the albumin level trends due to course of the disease and long standing cirrhosis causing decrease in the production of proteins causing decrease in the oncotic pressure leading to accumulation of fluid. as per the given clinical data due to chronic liver disease there was increasing trend of INR which was as high as 4.7 causing bleeding manifestations ( bleeding gums, hematoma formation ) ulcerations a
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38year old male with chronic liver disease

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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.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. A 38 yr old male who is a motor dweller came to op with c/o abdominal distension, loss of appetite, loose stools since 1 week  Pt was apparently asymptomatic 1 week back then he developed distension of abdomen and flanks are full not associated with pain  Loose stools of 5 to 6 episodes mucoid in consistency, small quantity and no  foul smelling Feeling of complete defecation + No history of loss of taste sensation No H/ of pain abd , vomtings, haematemesis, bleeding
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16 year old with Pancytopenia

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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.  This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome.  Case presentation :  A 16 year old female , who is a student came with chief complaints of low grade fever since 1 week      Patient was  apparently normal 1 week ago then she developed  low grade fever which was intermittent type usually seen in the afternoon , not associated with any chills and rigor, associated with dry cough .   No h/o cold , sob, vomitings, rash, loose stools,pain .    There is h/o jaundice with fever 1year back which decreased after hospital
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