GM Internal assessment 1



General Medicine
Internal assessment 1

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39 year old male patient from West Bengal

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This is a case of a 39 year old bus driver who is a resident of West Bengal. CHIEF COMPLAINT : Abdominal distension since 2 months. Swelling in the leg since 2 months. Decreased appetite since 2 months. Decreased urine output since 1 month.   HISTORY OF PRESENT ILLNESS- Patient was apparently asymptomatic 2 months ago then he developed abdominal distension which was insidious in onset and gradually progressive, associated with decreased appetite. Later he developed bilateral pedal edema extending upto the knees which is of pitting type. After a month his urine output got decreased still he continued his work as a bus driver. His relatives started noticing that his abdomen is getting distended and his appetite is decreased. They suggested him to see a doctor following which he took a homeopathic treatment in West Bengal But there was no improvement. He also took some ayurvedic medication but nothing seemed to work out. Then he came to our hospital with complaints of abdominal disten...
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OSCE and Learning points

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OSCE AND LEARNING POINTS PREFINAL PRACTICAL EXAMS NAME : VAGISHA RANI ROLL NO: 138 DATE: 4 December '23 Blog link: https://vagisharani.blogspot.com/2023/12/48-year-old-male-patient-from-west.html QUESTIONS  1) West haven criteria clinical grade for hepatic encephalopathy. 2) Wilson's disease and cirrhosis of liver  Wilsons diease is an inborn errors of copper metabolism characterised by increased total body copper. Etiology: Molecular defect within the copper transporting ATPase encoded by gene ( ATP7B) located on chromosome 13 Pathology:  Copper enters the body through the digestive tract with the help of a transporter protein in the cells of the small bowel, copper membrane transporter 1 (Ctr1; SLC31A1).  In response to rising copper levels, an enzyme called ATP7A releases copper into the portal vein to the liver. Liver cells carry the CMT1 protein and metallothionein, and then ATOX1 binds it inside the cell. Once here, ATP7B links the copper to cerulop...
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GM E-LOG :A 35 YEAR OLD FEMALE WITH SHRUNKEN RIGHT KIDNEY, RENAL CALCULI

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  A 35 YEAR OLD FEMALE WITH SHRUNKEN RIGHT KIDNEY, RENAL CALCULI NOTE This is an ongoing case and will be updated . This e log is made under the guidance of Dr. Pallavi. The reference link (if any) will be mentioned at the bottom. Date of admission : 13 July 2021 CHIEF COMPLAINT : A 35 yr old woman, who is a housewife in West Bengal, presented with   Pain in abdomen since 3 years  and  Lower back pain since 6 months H/o PRESENT ILLNESS:  Woman, mother of 3 children was apparently asymptomatic 3 yrs back.   She started experiencing pain in the right lumbar region radiating to the back since 3  yrs., and right upper thigh along with burning micturition .  On visiting a local hospital, was told to have 2 renal  calculi in her right kidney for which she had been put on certain medications, which reduced her pain.   She has been experiencing intermittent fever.    Since the past 6 months, she has been experiencing s...
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