General medicine 1st internal assessment

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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...
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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 Gen...
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A 40 year male farmer had come with chief complaints of Fever since 10 days, Lethargy since 4 days, Blood in saliva since 3 days and SOB since 2 days .

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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 a series of inputs available global online community of experts with the aim to solve the patient’s clinical problems with the collective current best evidence based inputs. This E log reflects my patient centred online learning portfolio and your valuable inputs in the comments section.  40 year male farmer had come with chief complaints of Fever  since 10 days, Lethargy since 4 days, Blood in saliva  since 3 days and SOB since 2 days . HOPI : Patient was apparently alright 10 days back then he had low grade fever , intermittent , relieved on taking medication . Not associated with chills and rigors and doing his routine works , from 4 days as patient was lethargic and taken to local hospital found out to be Dengue NS 1 + and platelet count was  44,000 on 1/3  ...
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