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A 20 YEAR OLD FEMALE c/o neck pain since 3 days c/o headache since 1 day, c/o vomiting since 1 day.

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A 20 YEAR OLD FEMALE C/o neck pain since 3 days C/o headache since 1 day. C/o vomiting since 1 day. HOPI :  Patient was apparently alright 3 days ago and then she had a B/L pitting type of pedal edema extending till knee, which was relieved on taking medication, later on she developed fever and hyper pigmented macules on the face, fever was high grade. Later she developed pitting type of pedal edema, Dry cough, abdominal distension, decreased appetite, decreased urine output. All her complaints subsided after she was treated. She was normal till 3 days. Then she developed neckpain, non radiating type and headache since 1 day. Past history : Not a k/c/o HTN, DM, ASTHMA,TB EPILEPSY, CAD. K/c/o SLE. She is on medication : 1)TAB.HCQ 200 MG PO/OF 2)TAB.AZATHIOPRIME 50 MG PO/BD 3) TAB.PREDNISOLONE PO/BD Personal history : Diet- Mixed Appetite- Decreased Bowel and Bladder movements- Decreased Family history- Not significant. O/E : patient is c/c/c. No pallor, No ict
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A 65 YEAR OLD MALE PATIENT FARMER BY OCCUPATION HAD BROUGHT TO CASUALITY IN ALTERED SENSORIUM SINCE 2HRS ON 27/11/2022 AT 8:00PM.

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A 65 YEAR OLD MALE PATIENT FARMER BY OCCUPATION HAD BROUGHT TO CASUALITY IN ALTERED SENSORIUM SINCE 2HRS ON 27/11/2022 AT 8:00PM. HOPI :  PATIENT WAS APPARENTLY ALRIGHT 1 DAY BACK AND THEN WENT TO FIELD AFTER CONSUMPTION OF ALCOHOL. SINCE THEN HE WAS DROWSY AND WAS TAKEN TO RAMANNAPET GOVT HOSPITAL AND WAS TREATED THERE FOR HIS GRBS-79mg/dl. HE WAS STILL DROWSY AND BROUGHT TO CASUALITY WITH ALTERED SENSORIUM AT 8:00PM ON 27/11/2022. PAST HISTORY :  HE IS A K/C/O DM 2 SINCE 2 YEARS AND ON MEDICATION T. METFORMIN 500 MG, T. GLIMIPERIDE 1MG. HE IS A K/C/O HTN SINCE 2 YEARS AND ON MEDICATION TELMA 4OMG. HE HAD H/O SEIZURES 2 YEARS AGO. PERSONAL HISTORY : Diet - Mixed Appetite-Normal Sleep-Adequate Bowel and Bladder movements-Regular Addictions- He consumes alcohol 90ml/day since 40 years.  ON  EXAMINATION :  PATIENT IS CONSCIOUS, INCOHERENT.  Moderately built and moderately nourished. No pallor, icterus, cyanosis, clubbing, lymphadenopathy, edema. VITALS: BP-140/80M
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SELF ASSESSMENT

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During the unit duty: Case: http://pranaykumar32.blogspot.com/2022/10/a-62-year-old-male-co-4-5-episodes-of.html 1) what is the cause of seizures?  Uncontrolled sugars.  2) Mechanism by which high  sugars cause seizures ?  A threshold glucose concentration is necessary to support synaptic transmission. Elevated extracellular glucose is associated with neuronal hyperexcitability, hyperglycemia exacerbates ischemia-induced brain damage.Hyperglycemia also lowers the threshold of seizure activity. This is the main mechanism by which diabetes induced seizures are most common.  3) Does hypoglycemia cause seizures?  Yes, extremes of sugars either high or low cause seizures.  A diabetic seizure occurs when the sugar levels in the blood are extremely low (below 30 mg/dL). The brain needs glucose to function properly. When there is a drop in blood sugar, the actions of the neurons in the brain decrease and the person experiences a seizure.  4) How seizure occurs in hypoglycemic condi
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A 55yr old female complains of fever,decreased appetite since 1 month, Breathlessness since 1 week,vomitings and loose stools since 3 days.

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CHIEF COMPLAINTS: Pt complains of fever,decreased appetite since 1 month, Breathlessness since 1 week,vomitings and loose stools since 3 days .  HOPI: Patient was apparently asymptomatic 3 months back. Then she had multiple swellings in front of the left ear, for which she developed fever which was lowgrade, intermittent, no evening rise of temp, ass with decreased appetite since 1 month. She then had vomitings which was non bilious and non projectile, containing food particles. She had history of loose stools since 3 days, which is 4-5 episodes per day, watery in consistency.  Past history: K/c/o  Hypertension since 7 years.  7 yrs back she had c/o giddiness for which she went to hospital and was found to have HTN.  Personal history: Diet- mixed Appetite-decreased Bowel and Bladder movements- regular. Addictions- Allergies- none General examination : Patient is conscious, coherent and cooperative. Well oriented to time, place and person. Moderately built and moderately nourished. No p
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A 62 year old Male, c/o 4-5 episodes of involuntary movements of both upper limbs and lower limbs since morning on 20/10/2022.

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Chief complaints: Pt c/o involuntary movements since morning 6-7 episodes since morning .  c/o uprolling of eyes.  HOPI:  Pt was apparently asymptomatic till morning. Then he had an episode of involuntary movements of both UL and LL at 6:30AM on 20/10/2022,which lasts  for 4-5 minutes with up rolling of eyes. Not ass with vomiting, involuntary micturition, defecation and no post ictal confusion.  No froathing,no tongue bite during the episode.  He had 5-6 similar episodes till afternoon . No developmental delay.  Past history: K/c/o HTN since 4-5 years Not a k/c/o DM, HTN, ASTHMA, CAD. No history of similar complaints in the past.  H/o surgery 4months back for? Intestinal ulcer and he stayed in hospital for 20 days.  Personal history: Diet- mixed Appetite-normal Bowel and bladder movements- regular. Addictions- He used to consume 90ml of whisky per day for the past 40 years. But he stopped consuming it 4 months back.  Allergies- none General examination : Patient is conscious, coherent
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A 45 yr old male c/o fever since 5 days.Abdominal pain , loose stools and vomitings since yesterday.

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CHIEF COMPLAINTS   :    A 45 yr old male c/o fever since 5 days, abdominal pain , loose stools and vomitings since yesterday. HOPI : patient was apparently asymptomatic   5 days ago and then developed fever, which is low grade, not associated with chills and rigors and relieved on medication. He complains of diffuse pain abdomen since 11th October morning. He had 3-4 episodes of vomiting on the same day evening, food particles as content and non- bilious in nature .He had loose stools since evening the same day, which is of 5 -6 episodes and so he went to local hospital. He developed weakness of both upper and lower limbs and found to be having low potassium, correction was done and the weakness got improved. He now came with c/o abdominal pain , vomiting and loose stools. PAST HISTORY Not a k/c/o DM, Hypertension, Asthma, epilepsy, CAD, CKD.  He went for a General checkup 6yrs ago, where he was diagnosed as HIV posi tive. He was on ART .  He met with an accident 3yrs ago and got Righ
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