gm 2nd internal assessment

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62yr old male with blackish discoloration of great toe,( post op bradycardia)

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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.  A 62 yrs old pt came to GS opd with blackish discoloration of left great toe since 15 days.   HOPI pta was apparently asymptomatic 3 months back and developed a blister on the left great toe and that has ruptured and formed an ulcer which is not healed and that  infection has gradually increased. 15 days back pt came to hospital with blackish discoloration of that great toe.  No h/o any fever No h/o itch
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60f with fever ( prefinal)

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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.  Date of admission: 27/11/23 A 60 yr old female came casualty with the chief compliants of          FEVER SINCE 10DAYS       PEDAL EDEMA SINCE 3 DAYS      GENERALISED WEAKNESS SINCE 4 DAYS      BLOOD IN STOOLS SINCE 3DAYS     CHEST PAIN AND TIGHTNESS SINCE 4DAYS HOPI: patient was apparently asymptomatic 10 days back and  developed fever which intermittent high grade not associated with chills and rigor.fever relieved
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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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