FIRST INTERNAL ASSESSMENT PAPERS








 
















































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 A 58 year old male, labourer by occupation, came to the OPD with the chief complaints of Shortness of breath since 30 days,which was worsened 1 day back(19/02/22), chest pain since 30 days ,facial puffiness since 30 days History of Presenting illness -   Patient was apparently asymptomatic 3 years ago then developed giddiness,  for which he went to a local hospital and was diagnosed as Hypertensive, for which he is taking T. Nicardia 10mg, T. Arkamine 0.1mg sos. Then 2 years back he  developed B/L pedal edema,  which progressed gradually to knees and  diagnosed with renal failure, started dialysis weekly twice. Since 4 months he developed left upper limb swelling and swelling at chest region,both of  which got  progressed to current size.  Back pain since 2 months, which got subsided on medication (T. Ultracet).  30 days back - he developed shortness of breath ,Grade II-III  which progressed to Grade IV since 30 days associated with orthopnea . Whereas from 4 days he developed right u
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A 65yr old M with Hypoglycemia,Hypotension

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 A 65 yr old male patient, resident of miryalguda came with chief complaints of  Hypoglycemia. Pt came with  Hypoglycemia with Grbs 30mg/dl. Pt came to the surgery department with c/o multiple ulcers over lt leg since 6 months. Pt was apparently asymptomatic 6 months back then he developed 4 small ulcers of size 1x 1 cm initially, which was gradually increasing to attain present size.H/o fever which was on and off. Then he suddenly developed Hypoglycemic symptoms and became unconscious  and transferred to medicine department.No H/o trauma  H/o Fracture at left elbow joint which was ill treated - Non union of Fracture 30 yrs back. Pt is a K/C/O of DM and is on regular medication - T. Glimestarmil PO/OD Had H/o pulmonary cox 2 yrs ago. N/K/C/O HTN,Asthma,Epilepsy.  Married He worked as a Sarpanch in his village. Have Normal appetite with mixed diet and regular bowel and bladder movements.  No significant family history  General examination  Pt is c/c/c .  No pallor,Icterus, Clubbing,Cyan
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1801006077 SHORT CASE

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 A 40 year old female patient ,hotel owner, resident of Narketpally came with chief complaints of Increased heartbeat since 6 months Breathlessness since 6 months HISTORY OF PRESENT ILLNESS : Patient was apparently asymptomatic 6 months back then she developed palpitations which were sudden in  onset, gradually progressive and develops under stress, heavy work. It lasts for 2 to 3 min and relives on rest . Since the last 2 to 3 months she complains of increased frequency and intensity of palpitations. She also complains of breathlessness ( shortness of breath) since 6 months and it was gradually progressive from grade 1 (6 months back)to 3 (presently)and it relieves on rest. Patient also has fainting attacks , headache when there is delay in food intake or prolonged standing and it gets relieved on taking rest or food. PAST HISTORY Not a known case of Diabetes, Hypertension, Asthma, Tuberculosis,Epilepsy, Thyroid disorders. Has acidity from past 15 years. She develops burning sensation
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