GENERAL MEDICINE 14/7/2023 INTERNAL

Gen Med 2 nd internal 14/07

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OSCE & LEARNING POINTS

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OSCE  • Which is the better afterload reducing drug? One of the classes of drugs commonly used to reduce afterload is vasodilators. Afterload refers to the resistance the heart has to overcome to eject blood into the systemic circulation. Vasodilators help dilate blood vessels, reducing this resistance and making it easier for the heart to pump blood. Several types of vasodilators are used for this purpose: 1. **Angiotensin-Converting Enzyme (ACE) Inhibitors:**    - **Examples:** Enalapril, Lisinopril, Ramipril.    - **Mechanism:** Inhibit the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor. This leads to vasodilation and reduced afterload. 2. **Angiotensin II Receptor Blockers (ARBs):**    - **Examples:** Losartan, Valsartan, Irbesartan.    - **Mechanism:** Block the action of angiotensin II on its receptors, resulting in vasodilation and decreased afterload. 3. **Calcium Channel Blockers:**    - **Examples:...
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PREFINAL PRACTICAL EXAM

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40 YEAR MALE WITH PAIN AND DISTENSION OF ABDOMEN , DECREASED URINE OUTPUT SINCE 2 DAYS  This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome  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 diagnosis and treatment plan • A 40 year old male pt , farmer by occupation resident of Nalgonda came with  Chief complaints  Pain abdomen 2 da...
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60 year old male , R/o Nakrekal , Farmer by occupation came with the Chief complaints  Decreased urine output since 20 days Abdomen distension since 1 week Shortness of breath since 1 week  History of present illness  Patient was apparently asymptomatic 20 days ago the developed high grade fever , continuous , assosiated with chills and rigors for which he was admitted to local hospital medications and they put foleys catheter and patient symptoms were  relieved . • Patient complaining of decreased urine output since 20 days  • Abdomen distension not a/w pain or tenderness  • SOB since 1 week  Grade 3 proggresses to Grade 4 .  H/o Orthopnea  H/o Burning micturation  No H/o PND  No H/o Vomitings , Loose stools  History of past illness  Patient had a trauma over right bigtoe which was not healing  for which toe was amputated 3 years ago Patient also had a trauma over right lateral aspect of leg . And healed 1 month ago ...
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