General Medicine Internal Assessment 2 july 2023 -192 Y.Srujana

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61 Y/O Male with shortness of breath

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This is srujana from eight semester.  This is an elog depicting  patients deidentified data centered approach for learning medicine.ll This log has been created after taking consent from  patient and his family. Here we discuss about patient's problems with a series of inputs with an aim to solve them Cheif complaints - Patient complains of shortness of breath since 1 yr Abdominal distension since 1 yr History of present illness:   The patient is apparently asymptomatic one year ago  then he developed shortness of breath and abdominal distension •shortness of breath-insidious onset , grade-3 (NYHA) , gradually progressive not relieved on taking rest and aggravated on walking History of left anterior septal deviation  History of abdominal distension -insidious onset not associated with pain ,tenderness  No history of loose stools and vomiting No History of orthopnea, PND and cough and  palpations No history of chest pain , upper respiratory tract i...
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osce

Osce #Mechanism of sulfonylureas-  These exert the hypoglycaemic action by stimulating insulin secretion from the pancreatic beta-cell. Their primary mechanism of action is to close ATP-sensitive K-channels in the beta-cell plasma membrane, and so initiate a chain of events which results in insulin release. Insulin through GLUT-4 translocation cause peripheral uptake on glucose hence,decreasing hyperglycemia. About Age related cataract and diabetic cataract - Age related cataract -usually detected in more than half population after 65 years  Diabetic cataract can occur even in younger age group as compared to age related cataract <65 yrs Age related cataract more common in females Diabetic cataract more common in males Age related cataract affects vision more as compared to diabetic cataract Diabetic cataract usually doesn't affect the vision but makes it difficult to examine fundus. Mechanism of diabetic cataract - the intracellular accumulation of sorbitol leads to osmoti...
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77/F WITH DECREASED VISION SINCE 7 MONTHS

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77/F DECREASED VISION SINCE 7 MONTHS 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 is Srujana Yadavalli (192) of 2019 batch. This is a case of 77 y/o Female with decreased vision since 7 months.She was referred from opthalmology dept to genmed dept as she had high blood glucose levels (of 558 mg/dl )which was found during the prerequisite screening for cataract surgery. History of presenting illness- The patient was apparently asymptomatic 1 year ago when she had h/o nocturia(>4-5 times),increased frequency of urination and thirst due to which she went to the hospital and was diagnosed with diabetes and was given medications. H/o increased appetite...
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