GENERAL MEDICINE ASSESSMENT:1



 I am,M.easha chandrika,MBBS 3rd semester, holding roll no:76

QUESTION :1

                    1:CARDIOLOGY 

CASE:

https://muskaangoyal.blogspot.com/2021/05/a-78year-old-male-with-shortness-of.html

A 78 yr old male patient ,

CHIEF COMPLAINTS:

 ▪︎ shortness of breath ,

▪︎ chest pain,

▪︎ bilateral pedal edema

▪︎ Facial puffiness 

HISTORY :

•chronic smoker since 30 yrs

•alcoholic since 30 yrs 

• diabetes mellitus since 1 yr

• hypertension since 1yr

INVESTIGATIONS:

■ Ecg

■ chest x -ray

■ 2d echo

■ usg abdomen 

■ blood reports 

DIAGNOSIS:

▪︎ acute pericarditis 

▪︎ heart failure 

▪︎ arterial premature complexes present 

                         》• Acute pericarditis •《

 Acute pericarditis is inflammation of the pericardium the flexible two-layered sac that envelops the heart, that begins suddenly, is often painful, and causes fluid and blood components such as fibrin, red blood cells, and white blood cells to enter the pericardial space.

   

                        》• Heart failure •《  

Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood to meet the body's needs for blood and oxygen. Basically, the heart can't keep up with its workload.A chronic condition in which the heart doesn't pump blood as well as it should 


QUESTION 3,4:

                 https://60shirisha.blogspot.com/2021/06/medicine-case-discussion_14.html?m=1

70 yr old female,

CHIEF COMPLAINTS 

▪︎  distension of abdomen

▪︎ shortness of breath 

HISTORY:

• hypothyroidism since 5yrs 

• no history of palpitations, pedal edema , fever cough ,fatigue  

• no history  of diabetes mellitus, hypertension 

INVESTIGATIONS:

▪︎ ECG 

▪︎ 2d echo

▪︎ troponin I 

▪︎ complete blood picture 

▪︎ serum electrolytes 

▪︎ c reactive protein

▪︎ blood urea 

DIAGNOSIS :

■ HFrEF with Atrial fibrillation 2 

                 》• Atrial fibrillation •《           

Atrial fibrillation is an irregular and often rapid heart rate that can increase your risk of strokes, heart failure and other heart-related complications. 

during atrial fibrillation, the heart's two upper chambers (the atria) beat chaotically and irregularly — out of coordination with the two lower chambers (the ventricles) of the heart. Atrial fibrillation symptoms often include heart palpitations, shortness of breath and weakness

Common symptoms include:

▪︎ palpitations, or the feeling of an irregular heartbeat

▪︎ breathlessness, particularly when lying flat

▪︎ chest pain or pressure

▪︎ low blood pressure

▪︎ dizziness, light-headedness, and fainting


TREATMENT:

✓ Inj. Amiodarone 150 mgIV stat (2 doses)

✓Inj.Amiodarone infusion

 1mg/min till 6hr f/b 0.5 mg/min for next 18 hours

✓ Inj.clexane 40mg Sc OD

QUESTION:5

As we are new to clinical postings I am  very excited .as they are conducting online it's very difficult to follow but it's really a kind of good experience.  It's very interesting to apply subjective knowledge to the clinical postings .I am very thankful to general medicine department for doing our job easier. 

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