Internal Assessment 1

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MEDICINE ASSIGNMENT By Prashanth Reddy Anugu( Roll no 107)

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  1) Pulmonology   1) What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patient's problem? Primary etiology could be repeat e d exposure to Actinomyces ( MICROPOLYSPORA FAENI ) leading to fibrosis blood vessels get compressed in the alveoli Increased Pulmonary vasculature resistance With due course of time right heart failure and the symptoms of right heart failure like pedal edema might have developed SOB has developed because of decreased compliance of lungs as a result of fibrosis                 5.What could be the causes for her electrolyte imbalance?    Heart failure can be a cause of electrolyte imbalance heart failure can cause decreased cardiac output  though a right heart failure : it can decrease venous return to the left ventricle impairing the cardiac output patient...
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A 27 yrs old female with complaint of ankle and wrist pain

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27 year old female came with chief complaints of pain over the both the wrists and ankle of both legs since 1 & 1/2 years History of Presenting illness Patient was apparently asymptomatic 1 &1/2 yrs back .  Way back in March 2019   : After 6 hours of sleep in the night she experianced pain , swelling , mild rise of temperature with restriction of movement of left elbow joint (slight flexion of elbow joint) which lasted for one and half year September 2020: she went for physiotherapy for the right elbow joint pain  Then 3-4 days later she started experiencing pain in the right ankle joint with pain, redness ,swelling over the joint . Pain was progressing and radiating from lateral to medial side and then to plantar aspect of foot  Not relieved on medication even after 15 days Feb 2021 : She started experiencing pain over right wrist joint  July 2021 : She started having pain of left wrist and left ankle as well  Pattern of involvement of the joints...
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70 yrs old male patient with c/o B/L great and second toe pain for the past 15 days

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70 yrs Old male came with complaints of B/L great toe and second toe pain since 15 days Patient was apparently asymptomatic 15 days ago. Then he developed pain at B/L Great and second toes which is associated with burning sensation, insidious onset , gradually progressive and not associated with h/o trauma H/o B/L Varicose vein present for the past 6 months No c/o fever , pain abdomen, loose stools, vomiting, burning micturition, cough , cold H/o NSAID abuse present  No c/o decreased urine output , hesitancy , frequency, urgency  C/o pedal edema (pitting type) on and off Previous reports 16/06/2023   USG abdomen - Grade 3 Renal parenchymal disease  30/06/2023     Serum creatinine 2.9 mg/dl Past history  K/c/o asthma for 2 yrs and on MDI SALBUTAMOL / SOS K/c/o Hypertension for 20 yrs and on TAB . AMLONG-AT PO/OD   K/c/o CAD for 10 yrs ( on irregular medication of TAB. ECOSPRIN -AV 75/10 Not a k/c/o DM , CVA , thyroid disorders H/o seizures one time...
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