General medicine 2nd internal























 

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A CASE WITH PAINFUL SKIN LESIONS PRESENTED IN SUMMER 2023

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NOTE: The following E-log aims at discussing our patient de-identified health data shared after taking the guardian's signed consent.  Here we discuss our individual patient problems through series of inputs from available global online community of experts with an aim to solve the patients clinical problem with current best evidence based input. This E-log also reflects my patient's centered online learning portfolio. I have been given this case to solve in an attempt to understand the topic of "Patient Clinical Data Analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with a diagnosis and providing treatment best to our skills and wisdom.  A 35 years old female , daily wage worker  by occupation came presented with chief complaints of painful skin lesions on B/L upper and lower limbs since 2 months, fever and burning micturition since 4days.  Date of admission: 12/09/23 CHIEF C
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BIOPSYCHOSOCIAL HISTORY OF 25/F PRESENTED WITH FEVER AND MULTIPLE SKIN LESIONS

BIOPSYCHOSOCIAL HISTORY OF A 25 F PRESENTED WITH FEVER AND MULTIPLE SKIN LESIONS OVER BOTH LEGS  WITH  SUSPECTED  SYSTEMIC LUPUS ERYTHEMATOSUS Case blog link : https://asjad24.blogspot.com/2023/10/a-case-of-sle-presented-in-october-2023.html PSYCHOLOGICAL HISTORY : Before Disease : Patient was brought up in a rural background with her father working as a stone cutter. Due to financial constraints and social backwardness she couldn't even attain the primary education. Although her family had financial crisis, there was no stress in the family.  She got married at an early age of 17 years(2015) and two children at 20(2018) and 23(2021) respectively which overburdened her shoulder with responsibilities at an early age. After that she started working as a daily wage worker with her husband.  During her second pregnancy she got rashes over her both the cheeks but she wasn't  worried about that and after labour she didn't even pay heed to it. She had cheerful marital life.  No h/
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General Medicine OSCE questions towards optimising clinical complexities.

 OSCE QUESTIONS: Case-  A 35 years old female , daily wage worker  by occupation came presented with chief complaints of painful skin lesions on B/L upper and lower limbs since 2 months, fever and burning micturition since 4days https://asjad24.blogspot.com/2023/09/note-following-e-log-aims-at-discussing.html BASED ON HISTORY AND BIOPSYCHOSOCIAL PROFILE  1)What factor suddenly triggered her skin lesions? 2)How long it took for her pain to progress in to severe deformity? 3)What investigations/diagnosis made her to take medication for RA? 4)What factors led her to stop medications for RA? 5) How did she manage to work even with severe deformities? BASED ON EXAMINATION  1)Why is she severely cachexic even after proper diet? 2)Is the violaceous hue around the margin of ulcer insinuate something? 3) What is the reason for her continous hypotension? 4)What is the reason for her severe anemia? BASED ON DIAGNOSIS AND MANAGEMENT  1) Why it can't be Raynaud's disease? 2)Why she was not
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