GM first internal assessment

OSCE

OSCE DISCUSSION OSCE CASE LINK: https://127soumyadeepbiswas.blogspot.com/2023/12/a-65-year-old-male-with-dka-with.html OSCE question and answers 1. What is diabetic ketoacidosis (DKA) ? Ans. Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes characterized by hyperglycemia, ketoacidosis, and ketonuria. It occurs when absolute or relative insulin deficiency inhibits the ability of glucose to enter cells for utilization as metabolic fuel, the result being that the liver rapidly breaks down fat into ketones to employ as a fuel source. The overproduction of ketones ensues, causing them to accumulate in the blood and urine and turn the blood acidic. DKA occurs mainly in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. Laboratory studies for DKA include glucose blood tests, serum electrolyte determinations, blood urea nitrogen (BUN) evaluation, and arterial blood gas (ABG) measurements. Treatment includes corr

A CASE OF 45 yr old male with CKD on MHD (Second degree Diabetic nephropathy)

Soumyadeep Biswas Roll no. 127 This is an online e-log book to discuss our patient's de-identified health data shared after taking his/her/guardian's 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. CASE : A 45 yr old male presented with fever , burning micturition , pedal edema CHIEF COMPLAINTS: fever Burning micturition Facial puffiness Pedal edema progresses to anasarca 5 sessions of Hemodialysis were done HISTORY OF PRESENTING ILLNESS: The patient has been readmitted to our hospital first dialysis was done on 5/09/21 No h/o pedal edema , oliguria and SOB (from past 7 days) HISTORY OF PAST ILLNESS: He is a known case of Diabetes mellitus (DM2) on medication ie. Actrapid Hypertension , on medication tab NICARDIA 20mg x PO x BD tab METXL 25mg x PO x BD Hypoth

38yr old male patient developing severe pain in groin area

"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. The history has been taken using telephonic method. Chief complaints: a 38yr old male patient complained of severe pain the groin area History of presenting illness: patient was apparantly asymptomatic 5days back and then developed severe pain in the groin region. The location of the pain is in the inguinal region which is continuous in nature and constant. The pain radiates to the back. The pain becomes intense with urination or any exertion, it is associated with mild fever ,

CASES IN GENERAL MEDICINE

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