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OSCE and LEARNING POINTS

 http://vinilabhavani.blogspot.com/2023/12/k-vinila-bhavani-case-of-63-yr-old-male.html  OSCE QUESTIONS 1. The sensitivity of diagnosing BPH or prostatomegaly by ultrasound? BPH appears in TRUS as an echogenic and non-mobile mass. TRUS is mainly used to assess prostate volume, which is crucial for therapeutic strategies. Prostate volume can be estimated by serial planimetry, orthogonal plane, rotational body (single plane, ellipsoid) and three-dimensional methods. Staging sensitivities in studies using grey-scale TRUS varied between 30% and 50% with specificities between 77% and 96%. Three-dimensional TRUS aided in the assessment of extracapsular extension and seminal vesicle invasion. 2. How does hypothyroidism affect urine retention?   In hypothyroidism there is loss of medullary hypertonicity impairing urinary concentration ability of kidneys . In hypothyroidism there is a reversible increase in vasopresssin sensitivity causing increased water reabsorbption  3. What are the  causes
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K Vinila Bhavani A case of a 63 yr old male with decreased urine output and sob

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This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings investigations and come up with diagnosis and treatment plan. A 63 yr old male resident of Ramanpeta a retired accountant came to the OPD with CHIEF COMPLAINTS: decreased urine output since 1 day Shortness of breath since 1 day HISTORY OF PRESENTING ILLNESS: Patient was ap
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This is K.Vinila Bhavani , 8 th sem student .This Elog depicts patient centred approach to learning. This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input.This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome.I have been given this case to solve in an attempt to understand the topic of “ patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan.

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A 40 yr old male patient , resident of mirualguda , who is daily wage labourer by occupation came to OPD with chieft complaints of pain abdomen since 5 days associated with fever since 2 days . History of present illness  Patient was apparently asymptomatic 5 days ago then he developed pain which is insidious in onset and gradually progressive which is diffuse , squeezing type and radiating to back .Pain is relieved on medication . No C/O of vomitings , loose stools , burning micturition ,cough,cold , chest pain , SOB . History of past illness N/K/C/O  TB , hypertension, diabetes, Asthma, epilepsy , CAD, thyroid disorders . Personal history  Diet - mixed  Appetite- normal Bowel and bladder -regular Sleep - adequate Addictions - regular alcohol intake of 250 ml per day since 20 yrs . No food allergies and drug allergies Family history  Not significant General examination Pallor - yes  Edema - no  Clubbing - no  Lymphadenopathy - no  Icterus - no  Vitals -  Temperature - 100.1F BP-85/60
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Gm internal exam sheet

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CHIEF COMPLAINTS: A 54yrs old female who is a housewife from Nalgonda came to opd with chief complaints of SOB since 2days and generalised weakness. HOPI: Patient was apparently asymptomatic  8 months ago then she developed SOB which is insidious in onset and continuous in nature which aggravates on walking and also on lying down.It gets relieved on sitting position [grade 3 SOB].It is also associated with dry cough.She also has genearalised weakness and also fever since 8months which is intermittent in nature. She consulted a local doctor in Nalgonda from where she got to know that she has low Hb levels for which she underwent blood transfusion and again back in July her Hb levels were found low[5.0g/dl] and again she underwent blood transfusion[2units] after which her Hb levels increased from 5.0 -8.0g/dl.She again developed SOB and generalised weakness since 2days for which she again consulted a local doctor in Nalgonda and got her tests done. Now her Hb levels have got down within
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 A patient who is 45 yr old male came to OPD with chief complaints of fever since 2 days and blurring of speech since 1 day . HISTORY OF PRESENT ILLNESS  Patient is a daily wage worker by occupation  . Patient was apparently asymptomatic 2 years back then his appetite increased( about 5- 6 times a day ) for which he came to KIMS hospital and diagnosed with Diabetes.He used oral hypoglycemic drugs for first 6 months.Then from past 1.5 years he is on insulin.He was a chronic alcoholic since 25 yrs . he consumes more than 180ml / day . Urine output increased since 2 years about 10 times a day. Decreased weight about 25kg since 2 years. Then since 2 days he developed  fever which was high grade, continuos and associated with chills and rigor and also presence of neck stiffness and burning Micturition.Patient was also anemic for which he received blood transfusion He developed slurring of speech since 1 day then he came to hospital the next day     HISTORY OF PAST ILLNESS  Patient is a  K/c
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I am Vinila , student of 5th sem

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 A 45 yr old male came to OPD with chief complaints of fever since 4 days associated with left sided loin pain . Patient also presented with breathlessness and abdominal fullness since 2 days . HISTORY OF PAST ILLNESS      Patient is a plumber by occupation and is apparently asymptomatic 14 yrs back later he was on medication for infertility ( he used both herbal and generic medicine ) for 6 months continuously and as a part of health check up he was diagnosed with Diabetes 10 yrs back . He received treatment for infertility irregularly for  about 7 yrs . Patient adopted a girl child 9 yrs back . Patient suffered with loin pain 6 months back for which he was treated by RMP and it was relieved , now since 4 days patient had fever associated with vomitings , chills and rigor. Fever not relived on medication. He also had left lumbar region pain and shortness of breath that relieved on sitting . HISTORY OF PAST ILLNESS Patient is a  K/c/o DM  Not a k/c/o asthma , hypertension,CAD , tubercu
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