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68F WITH FEVER AND ABDOMINAL PAIN

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 A 68 YEAR OLD FEMALE CAME TO OPD WITH COMPLAINTS OF PAIN ABDOMEN SINCE 4 DAYS  FEVER WITH CHILLS SINCE 4 DAYS VOMITINGS AND ABDOMINAL DISTENSION SINCE 3 DAYS CONSTIPATION SINCE 2 DAYS PATIENT WAS APARANTLY ASYMPTIMATIC 1 WEEK BACK THEN SHE HAD COMPLAINTS OF LOOSE STOOLS 3-4 EPISODES WATERY,NOT ASSOCIATED WITH BLOOD AND MUCOUS, LARGE VOLUME,BLACK COLOURED LASTED FOR 2 DAYS,THEN SHE HAD COMPLAINTS OF PAIN ABDOMEN,DIFFUSE,SQUEEZING TYPE ASSOCIATED WITH  COMPLAINTS OF FEVER  WITH CHILLS,INTERMITTENT,NO EVENING RAISE OF TEMPERATURE ,WITH VOMITINGS,BILIOUS,NONPROJECTILE FOR 4 DAYS AND ALSO COMPLAINTS OF  OBSTIPATION SINCE 2 DAYS CLINICAL CASE OF DIABETES MELLITUS SINCE 10 NYEARS ON MEDICATION. NOT A CLINICAL CASE OF  HYPERTENSION,TB,ASTHMA,CAD,EPILEPSY,CVA   PERSONSAL HISTORY MIXED DIET APPETITE:LOST SINCE 1 WEEK SLEEP: ADEQUATE CONSTIPATION SINCE 2 DAYS BURNING MICTURITION SINCE 10 DAYS ADDICTIONS NONE   GENERAL EXAMINATION PATIENT IS CONSCIOUS ,COHERENT,COOPERATIVE  NO PALLOR,ICTER
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58 M with acute asymmetrical polyarthritis

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 COURSE OF LIFE EVENTS:PERSONAL HISTORy 58 male hailing from narayanapuram ,choutuppal, born in 1964 A 6 years got seizures,  from 7th class he got one sided headache associated with bilious vomiting ( stopped at 32 years) studied until 10th class ,kabaddi player long jump(13feet) ,  he started smoking, From 1990 he started consuming alcohol,1994 he got job as a  supervisor in mumbai , got addicted to gambling and alcohol 75ml per day for 15 years , usually smokes 30 cigarrette per day for 15 years , Rich person at those times, usually takes high protein diet.  admitted in hospital for cold with  headache done spinal injection( lumbar puncture ? meningitis?)for 20 days . He quit smoking and alcohol there after .He quit job in mumbai due to some brother disputes and lost his money .He does real estate and also upasarpanch has anger episodes in 2000s ,he got swelling at 1st MTP with severe pain , swelling developed in a day  , joined in a hospital for 10 days but no diagnosis , then afte
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50F with pyrexia under evaluation

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  50 year old female, health care worker ( aayamma in orthopedic hospital ) resident of miryalguda presented with complaints of fever since 1 week, nausea and vomitings for 3 days, Rt shoulder pain since 1 week. She works in a orthopaedic hospital, does washing of patients clothes, OT gowns, other clothes with cleaning the hospital premises when ever it’s necessary. After reaching home she manages to do her work and take rest. In 2005 when her parents went to daily work ( daily waged labourers ) met with an road accident and expired, following which in there memory she tattooed there names on her right forearm. ( similar tattoos where present on her both knees, couldn’t give exact reason for them ). Since 10-11 year she had both knee joint pains for which she took analgesics with a frequency of 4-5 per month which did not effected her daily routine. Her son got married 10 years back, with daughter in law entering into her family, she got some rest and continues to work in hospital. Sin
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45 year F with diabetic neuropathy

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 45 F at 16 years female child nvd at 20 years female childnvd at 23 years female child nvd husband died 28 years ago ,cirrhosis of liver. 10 years ago  diagnosed as diabetic( 240mg/dl )checked due to  increased frequency  of urine on metformin. 2 years ago , typhoid fever 3 days fever high grade fever with chills and rigors , weight loss started then she noticed prominence of veins on right leg then on left leg upto knee, itching sensation present from buttocks to feet . she used to sell fruilts at this time After 5 months bilateral dragging type of pain in lowerlimbs aggravated on walking for 200 meters and relieved on standing for few minutes.  she quit selling fruits due to this pain and started working in hostel ,after 4 months patient started having burning sensation of both lowerlimbs proximal to distal from knee to feet . then after 3months then she complains bilateral upper limb pains burning sensation from shoulder to fingers , this burning sensation aggravated on full bladde
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60F with UTI and CAD

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  A 60 year old female came to casuality with chief complaints of fever with chills , nausea, vomitings , pain abdomen since 4 days  Patient was apparantly asymptomatic 4 days ago then she developed fever which is high grade associated with chills , intermittent in nature relieved by medication associated with pain abdomen , with nausea and vomitings vomitings are non bilious , nonprojectile contains food particles h/o burning micturition since 4days with no increased frequency in urine 9i patient complains of chest pain , non radiating type  COURSE OF EVENTS IN HER LIFE: patient ,  agricultural labourer works in jowar fields and in poultry , married at a age of 16  at 18 she attained menarche  first child birth at 20 year second child birth at 22 years She usually eats jowar instead of rice till 40 years , she shifted to rice from 40 years ,  At 42 years patient has excessive bleeding for which hysterectomy has done at 48 years she had an episode of fever with chills admitted into a h
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My experiences with general cellular and neural cellular pathology in a case based blended learning ecosystem's CBBLE "

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  As keen learner, i want to share some insights of me and my medicine journey, theres a patient , who came to medicine department with a bruise that doesn't heal , her bt ct was prolonged and her platelet count is 6000,  i was  stunned by seeing her counts, and she was admitted,immediate platelet transfusion was planned, and she had idiopathic thrombocytopenic purpura, tried steroids got pedal edema and many more side effects, she used to do weekly hemogram counts are maintained at 60,000, one fine day , she started have nleeding,menorrhagia,melena,her platelet counts fallen rapidly,SHE is on azathioprine,eletrombopag, iv ig  and high dose steroid injections to get the platelet count higher, no use ,she suffered from side effects, there comess the RITUXIMAB, the wonder drug, after she tried it, her platelet count, drastically improved without any relapse. I observed a complete medical case and monitored the entire treatment process until the patient was cured. I learned a lot in h
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