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K Vinila Bhavani

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 65 yr old female patient , who is a daily wage labourer came to casualty in altered state  with complaints of : Episodes of slurring of speech since 1 day  Profuse sweating that resolved on having food. Patient was asymptomatic till yesterday 4 pm . patient was brought to casualty in uncounsious state   HISTORY OF PRESENT ILLNESS : Patient has no involuntary movements . Patient has history of sweating and snoring . HISTORY OF PAST ILLNESS : In 2014 patient was discovered with GIST - gastrointestinal stromal tumour on histopathological examination.  In 2016 patient was found to be Mets+ve and was treated with anticancer drugs . In 2019 he was again found to have Mets 16mm in liver . Eye movements1, verbal1, motor4  PERSONAL HISTORY : Diet - mixed  Apetite - normal Bowel movements - regular  Micturition - normal Patient use to drink alcohol occasionally . THERE IS NO RELEVANT FAMILY HISTORY . Patient was having diabetes . VITALS  Pallor - yes...
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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  ...
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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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