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80 YR OLD MALE WITH COUGJ AND DIFFICULTY IN BREATHING.

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This is an a 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. The patient/ attender was informed the purpose of the information being acquired. An informed consent was taken from patient/ attender and there is omission of information that was requested to be omitted.  80p year old male with  cough and difficulty in breathing since 2 years  An 80 year old male patient, farmer by occupation, resident of Nalgonda came to the hospital with  CHIEF COMPLAINTS of cough and difficulty in breathing since 2 years, which  aggravated since 2 months  HISTORY OF PRESENTING ILLNESS  Patient was apparently asymptomatic 2 years ago then he had complaints of shortness of breath which was insidious
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GENERAL MEDICINE BIOMONTHLY ASSIGNMENT

AUGUST 23rd, 2021 2k19 batch ; 3rd sem QUESTION - 1 LONG CASE: This is primarily a case of Acute glomerulonephritis, likely due to Secondary Amyloidosis due to Chronic Poorly Treated Seronegative Erosive Rheumatoid Arthritis. The patient presented with bilateral, symmetric, pitting type of edema which was extending upto the middle of his leg. The patient also had chronic pain in the joints leading to restriction of movement since 2011. Upon previous hospital visits, the RA factor was negative. Therefore, the patient was prescribed analgesics and sent home. Chronic use of analgesic drugs was seen from 2011-2019, the details of which were undocumented. Hyperuricemia was also observed in one of his recent visits during last year and Febuxostat was prescribed as it has proven to be more effective than Allopurinol in recent studies. Anasarca was the chief complaint of this visit for which through testing and examinations were done. Liver and cardiac causes were ruled out and renal pathology
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73yr old male

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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 series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.  Case Scenario A 73 yr old male came to medical OPD with chief complaints of fall ( slipped) when he went for urination . HISTORY OF PRESENT ILLNESS Yesterday morning at around 5:00 Am pt went for urination at outside and fainted and fell on ground and no post fall Loss of consciousness, seizures, vomitings pt walked and slept. At around 8:00 Am pt couldn't walk and was taken to pvt hospital  Investigations were done showing Hyponatremia, low serum osmolarity with high spot sodium Euvolumic state  CT brain shows diffuse cerebral atrophy with small vessel ischemia   2D Echo shows WNL Na+ 206,K+
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