Medicine prefinals papers 1 and 2


























Paper-2





























 

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70yr old male with altered sensorium secondary to ?Meningitis

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  Sri Nithya Roll.no-86 ICU-BED. NO -03 A 70 Years Old Man Who was a Farmer By Occupation Presented to Casualty With  Altered Sensorium Since 3 Days  Fever Since 20 Days  HOPI :  Patient Was Apparently Asymptomatic Till 2014 ; 2014 - Patient Had Fever Associated with Cough for which he went to Hospital & Was Diagnosed to Have ? Pneumonia with DENOVO DM2 & Was Prescribed with OHAs ( Tab.METFORMIN & Tab.GLIMIPRIDE ) 6 Months Back - Patient Had Fever Associated with Cough for Which he Went to Hospital & Said to Have High Sugars along with Lung Infection ; Got Treated & Discharged in a Hemodynamically Stable Manner.Started using insulin for Diabetes Since Then  20 Days Back : Patient Had Fever with Cough ; For Which He went to Hospital & Suspected to Have TB But Reports Turned out to be Negative & Patient Discharged as LAMA & When He Returned Home 3 Days Back He Gradually Developed Altered Sensorium & Couldn't Recognise His Attendants Past History :
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  CASE-1 1) Pulmonology (10 Marks)    A) Link to patient details:     https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html   Questions:   1) What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patient's problem?   2) What are mechanism of action, indication and efficacy over placebo of each of the pharmacological and non pharmacological interventions used for this patient?   3) What could be the causes for her current acute exacerbation?     4. Could the ATT have affected her symptoms? If so how?     5.What could be the causes for her electrolyte imbalance?   1)EVOLUTION OF EVENTS OF SYMPTOMATOLOGY    1)shortness of breath which is on and off since 20 years.     2)pedal  edema since 15 days up to the level of the ankle, pitting type. 3)facial puffiness since 1
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65 year old female with complaints of involuntary movements of left upper limb since 1 day, cough since 4 days

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 M. Sri Nithya Roll. No -86 Unit-2 Chief compliants A 65 yr old female patient came to casualty with complaints of involuntary movements of Lt upper limb since 1 day  Cough since 4 days  HOPI  Pt was apparently asymptomatic 1 week ago then she developed generalised weakness , fell down from bed and complaints of pain in the hip  Involuntary movements of lt upper limb since 1 day to and fro  No history of speech abnormalities , weakness in the upper limb and lower limb . No H/o memory loss and abnormal posturing . Complaints of cough since 4 days ,it is productive scanty sputum - white to yellow ,non blood stained and non foul smelling  H/o inadequate controls of sugars from 4 months  N/H/o vomiting ,sob,loose stools ,pain abdomen K/c/o type 2 DM since 30 yrs on infusion since 10 yrs  ( Insulin - lispro 20-x-20 ) K/c/o HTN from 20 yrs on T prolomet - xl 50 mg  T. Atenolol 25 mg po/ od at 10 am K/c/o hypothyroidism from 15 yrs on thyronorm 75 mcg Previous treatment history Hospitalised 1
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