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Osce and learning points

  1.indications for dialysis ?       1.plasma urea >180mg/dl        2.hyperkalemaia >6mmol/l       3.metabolic acidosis       4.fluid overload and pulmonary edema        5.Uremic encephalopathy        6.creatinine levels >6.8.g/dl 2.why patient not recovering from sedation since 2 days?   1.normally metabolites of midazolam eliminated by kidneys.but in this patient kindney functions are impaired,because of impaired elimination prolonged action is seen.sedation also prolonged.    2.midazolam administration along with atorvastatin results in delaying elimination.so midazolam administration along with atorvastatin is not recommended. LEARNING POINTS;    1.i have learned about importance of clinicals along with theory . 2.l have learned about types of heart failure,clincal features, management of heart failure. 3.importance of contraindications and drug interaction while prescribing medications. 4.imporatance of control of comorbidities.

GM e-log

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 K Aravind,roll no 55,9th sem.    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. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment.  A 67 year old Male R/O Devarakonda , came to the casualty 5days back with complaints of Shortness of breath since 10 days and pedal & facial edema since 8 days.  History of presenting illness; Patient was apparently asymptomatic 10 days back , then he developed Shortness of breath which is insidious in onset, gradually progressive in nature, aggravating on exertion and relieved on taking rest, progressed from grade II to grade III- IV (Modified MRC

GENERAL MEDICINE E-log

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Kanakam Aravind,9th sem,roll no 55 This elog depicts the patient -centered approach to learning . This is an online E log book recorded to discuss and comprehend our patients de-identified health data shared , after taking his /her /guardians signed informed consent . This elog also reflects patients centered learning portfolio. 75Y F with involuntary movements of upper ,lower limbs and face since past 5hours. Chief Complaints: Patient came to casualty with H/O 2-3 episodes of involuntary movements of right upper and lower limb and face since evening(28/10/23) HISTORY OF PRESENTING ILLNESSES; Patinet was apparently asymptomatic till today afternoon after she which she started having involuntary movements of right right upper and lower limbs associated with up rolling of eye balls and frothing not associated with involuntary micturation and defecation associated with postictal  confusion for 15-20min. H/o seizure activity on and off from past 3years and is on medication. No h/0 fever an

GENERAL MEDICINE E-log

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 K Aravind,9th sem,roll number 55 This elog depicts the patient -centered approach to learning . This is an online E log book recorded to discuss and comprehend our patients de-identified health data shared , after taking his /her /guardians signed informed consent . This elog also reflects patients centered learning portfolio. 55 year old male came to opd with CHEIF COMPLAINTS o f fever and yellowish discoloration of eyes and tongue( jaundice) since 15days HISTORY OF PRESENTING ILLNESS; Patient was apparently asymptomatic 15 days ago when he developed fever which was insidious in onset, low grade, gradually progressive in nature, associated with chills and rigors. No hlo loose stools, vomitings Pedal edema was noted by patient 2 days ago, pitting type No h/o decreased urine output or burning micturation. H/o cough since 1 day, non productive, dry cough. No hlo chest pain, palpitations and sob H/o yellowish discoloration of eyes and tongue since 15 days No h/o bleeding per rectum, haem