GM Internal assessment 1



General Medicine
Internal assessment 1

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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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59 year old female

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This is a case of a 59 year old professor who is a resident of West Bengal. CHIEF COMPLAINT : Case of  Rheumatoid arthritis under medication.   HISTORY OF PRESENT ILLNESS- Patient was apparently asymptomatic an year and half ago.  Then she felt pain in her left wrist joint which was insidious in onset and gradually progressive in nature. It slowly progressed to the hands and shoulder on both the sides with an increased intensity causing difficulty in daily activities and sleep. She used painkillers which provided relief for sometime.  She underwent a physiotherapy for a month. She also took steroid injections twice in a local hospital in West Bengal but the pain reappeared later. There is no history of swellings, morning stiffness, malaise, musculoskeletal pain, weight loss,fever or rash. On February 2022, she went to a specialist in Hyderabad, who suggested her some medications but there was no improvement. Later she went to an OPD in Nalgonda and she got relieved f...
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65 year old male

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65 year old male from beemanapally Date of admission 21/7/23 65 yr old male agricultural labourer by occupation came to OPD with C/O abdominal pain, lower back pain radiating to b/l lower limbs, neck pain with stiffness since 1 year.  History of present illness:   Patient was apparently asymptomatic 1 year ago later he developed pain in abdomen which Insidious in onset gradually progressive. It is diffuse and dull causing discomfort.It is aggravated on eating,performing daily activities and walking. Pain in the chest is lasts for 2-5 min which is sudden in onset.It is relieved by massaging that particular area. Yesterday night patient complained of pricking type of headache due to dental carries on the right lower molars due to which he was unable to sleep.   Past illness: Diabetes since 15 years. Not a K/C/O  HTN, TB, asthma, epilepsy or any other chronic illness. History of Trauma 4 years back, then he had a fall while taking his cattle to the field due to which th...
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