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Bimonthly assessment _MARCH

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https://ashakiran923.blogspot. com/2021/03/60-years-old-male- fever-under-evaluation.html?m= 1 a). What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings?How specific is his dilated superficial Abdominal vein in making diagnosis? Ans: Based on the clinical symptoms and signs, the clinical diagnosis of the patient can be-  UTI with cirrhosis of liver with portal hypertension About his superficial abdominal veins :  For a long term alcoholic, he could be a risk factor to develop portal hypertension, which may be present with superficial abdominal veins and varices  Other differentials include: Caput medusae due to portal hypertension Dilated veins in IVC Congenital Obstruction of IVC b) What is the etiology of the current problem and how would you as a member of the treating team arrive at a diagnosis? What is the cause of his hypoalbuminemia?Why is the SAAG low? Ans: The etiology of the disease in
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Monthly assessment _MARCH_M.NAVYA CHOWDARY

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  https://ashakiran923.blogspot. com/2021/03/60-years-old-male- fever-under-evaluation.html?m= 1 a). What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings?How specific is his dilated superficial Abdominal vein in making diagnosis? b) What is the etiology of the current problem and how would you as a member of the treating team arrive at a diagnosis? What is the cause of his hypoalbuminemia?Why is the SAAG low? c)Will PT,INR derangement preceed hypoalbuminemia in liver dysfunction??Share reference articles if any! d)What is the etiology of his fever and pancytopenia? e)Can there be conditions with severe hypoalbuminemia but no pedal edema? Can one have hereditary analbuminemia and yet have minimal edema? Please go this article  https://www. frontiersin.org/articles/10. 3389/fgene.2019.00336/full  and answer the question.  f) What is the efficacy of each of the drugs listed in his current treatmen
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 Let's individually categorise and tackle her problems 1 by 1 36/F with a background of Chronic T cell mediated Immunosuppression with HIV Presenting with 6 month Hx of Dyspnea, Cough and Expectoration Her past Hx is significant for two cardiac surgeries. Now whether they have any bearing on the current problem, remains to be seen.  Cough and expectoration with Dyspnea strongly favouring a lung cause. Sputum + for AFB. So this explains her lung problem, her dyspnea and her systemic symptoms.  Her current problem is Jaundice and it appears that from the history of urinary excretion of bile salts and pigments (need to see the CUE), and the labs showing a Conjugated Hyperbilirubinemia, this is a cholestatic jaundice. So let's review the hepatic plumbing system here - 80% via Portal Vein and 20% via Hepatic Artery. Spleen being the major destroyer of RBCs releases unconjugated bilirubin, which is immediately bound to Albumin and then transported to the liver via splenic vein and po
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15yr old female with anemia under evaluation

 History taken by Dr.Chandana Vishwanatham Dr. Sai charan  Dr.Susmitha 15year old female who is the first child of a consanguinous married couple her mother expired during the birth of 3rd child She has 2 younger brothers who are apparently alright with no health related issues Since childhood she has been having recurrent Respiratory tract infections(She almost always had cold,fever,cough with sputum) aggrevated during winters Since 4yrs she is complaining of yellowish discoloration of eyes on and off not preceeded by fever with no h/o pruritus,No history s/o CLD h/o easy fatigability , generalized weakness since 4years associated with loss of appetite,progressed to great extent in the last 2 to 3months h/o short stature,failure to gain weight appropriate for her age and delay in secondary sexual characters Attained menarche in 2020 October and now has 2months h/o of ammenohrea 4years back(2016) she had h/o jaundice and anemia for which one blood transfusion was done,her jaundice subs
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