ACTIVE CLINICAL LEARNING - GENERAL MEDICINE

 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

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.            The patient/ attender was informed the purpose of the information being            acquired. An informed consent was taken from patient/ attender and                 

29/M presented to General Medicine OPD for routine check up.  History : Patient got married in 2021 and in June 2022 he got swelling in right side of neck around cervical region. Swelling was insidious in onset and gradually progressive. On consultation he had FNAC done and diagnosed as extra pulmonary tuberculosis. Previous reports are not present as patient threw them. He was put on medication for tuberculosis from June 2022 to March 2023 that's for 9 months.  In September 2023 patient was planning to conceive for which he got his full body check up where his ALT, AST and ALP were raised. Due to some engagements he didn't approach medical care. Then in November 2023 he came to our hospital with same reports (attached below).  Daily Routine  5 am : he wakes up  6am : he signs in for work and also takes one egg with one glass of milk.  8 am : he takes breakfast sometimes idli sambhar and some times dosa sambhar.  11am: he takes juice 1pm : he takes lunch one plate rice, dal and

1. Charan sir   Case - SLE Link -  https://drsaicharankulkarni.blogspot.com/2022/12/20f-sle.html 2. Rohit sir (2018)  Case - SLE Link - https://159rohithreddy.blogspot.com/2023/04/35-yrs-old-male.html 3. Manvi Ma'am (2018)  Case -  Dermatomyositis  Link - https://manvisharma88.blogspot.com/2022/03/35-yo-f-with-bl-pedal-edema-sob-and-bl.html 4.  Vagisha  (2019) Case - Rheumatoid Arthritis  Link - https://vagisharani.blogspot.com/2023/08/59-year-old-female.html?m=1 5. Asjad  (2019) Case - Rheumatoid Arthritis with Pyoderma Gangrenosum and SLE Link - PaJR link : https://chat.whatsapp.com/FGlVATIcOlrJD1xGxO1RaQ https://asjad24.blogspot.com/2023/09/note-following-e-log-aims-at-discussing.html https://asjad24.blogspot.com/2023/10/a-case-of-sle-presented-in-october-2023.html PaJR link :  https://chat.whatsapp.com/DPv5cw25MbwBMgtuqkARiM 6. Sipra  (2020) Case - CIDP Link - https://siprapattnaik.blogspot.com/2023/06/the-following-e-log-aims-at-discussing_7.html 7. Shreya  (2020) Case - RA Li