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78 years old female with giddiness and a history of fall

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This is a case of 78 yr old female who was brought to the hospital with history of giddiness since 3 days  She had history of fall 3 days ago following with she had an injury on left hand. She was unable to walk since 1 day She was having drowsiness & vomitings since today morning.  • HOPI √She was apparently normal 8 days back when she had giddiness and history of fall , following which she sustained injury to the left hand where she developed swelling, blebs  and had difficulty in walking. √She had complaints of vomitings 2 episodes with food as content. √she was given Ceftriaoxne for 3 days by local RMP.  • PAST HISTORY √ She has a history of admission in hospital in February, with complaints of vomitings, altered sensorium no clear history about the treatment is known. √ history of diabetes since 10-15 years and is on  √history of  hypertension since 10 years and is on √not a k/c/o asthma, Tb, CAD, epilepsy TREAMENT HISTORY:- She was on unknown medi...

intern online assessment - General medicine

General medicine case Intern online assessment -General medicine During units duty Case 1 https://amitsharma1996.blogspot.com/2022/09/27-yr-old-student-with-fever-and.html My orientation around this case: 1.What could be the possible cause if his anemia? Ans: possibily vit - B12 deficiency 2.Why vit- B12 deficiency and not some other cause?  Ans: 1)his peripheral smear showed few macrocytes.  2) patient consumes low non-veg diet. 3) his serum iron and serum ferritin level was in normal range. 4) his vit-B12 was lower than normal range. Case 2 https://amitsharma1996.blogspot.com/2022/09/a-19-year-old-male-with-fever-and-body.html Case 3 https://amitsharma1996.blogspot.com/2022/09/a-84-yr-old-male-with-tremors-swelling.html My orientation around this case:  1.What could be the reason for he being suspected for Parkinson's?  Ans:Due to presence of tremors, slowness of movement, loss of balance.  2.cause of his cellulitis ?  Ans: injury due to reccurent fall....

A 19 year old male with fever and body pain

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 A 19yr old male patient came to the opd with chief complaints of fever Since 1 week. HOPI:- Patient was Apparently asymptomatic 1 week back then he developed fever with chills which is high grade ,sudden in onset & associated with body pains .Relieved on medication. 2 days back he was taken to outside hospital there his platelet count was 1,29,000 cells/cumm, yesterday they were 1,32,000cells/cumm.Today they were 98,000cells/ cumm. No h/o Loose stools, vomitings, No h/o Hematuria, dark stools. No h/o pain abdomen,giddiness. PAST HISTORY:- Not a k/c/o HTN,DM, Thyroid, Epilepsy. PERSONAL HISTORY:- diet- mixed Appetite- normal Sleep- adequate Bowel and bladder movement- normal GENERAL EXAMINATION:- Patient was conscious, coherent, cooperative,well oriented to time place and person. Moderately built & moderately nourished. No pallor,Icterus,cyanosis, lymphadenopathy, clubbing. BP -90/60mmhg PR -84 RR -14cpm Spo2 -99 Temp:-99.5 F CVS- S1 S2 + CNS- NAD R/S - BAE + P/A - soft,non...