"MY EXPERIENCES WITH GENERAL CELLULAR AND NEURAL CELLULAR PATHOLOGY IN A CASE BASED BLENDED LEARNING ECOSYSTEM'S CBBLE "

 NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS/HER GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT

Welcome

I’m Samba shiva would like share some real medical case scenarios within my career. I am dedicated and committed to continuous learning process and effective communication to provide the best health care to my future patients.

Here I like share my summary about the cases seen in my career:

First I would like share my interests in medicine. I would like in dealing with respiratory cases; it’s my interesting subject. One of the typical cases we seen are about bronchial asthma and chronic obstructive pulmonary diseases. The barrel shaped chest, wheezing, rhonchi, hyperinflated lungs, tubular heart and flattened diaphragm, increased lung volumes and PEFR(peak expiratory flow rate increased.

https://shiva1d4.blogspot.com/2022/12/69f-with-shortness-of-breath.html

Most common infectious respiratory diseases encounter in our area(India) is tuberculosis. In our country most of the immunocompromised patients suffer from tuberculosis because our country is high epidemic for tuberculosis.

https://shiva1d4.blogspot.com/2023/04/no-202-70-year-old-male-with-cough-sob.html

Another fascinating case that I have seen is about aspergilloma (fungal balls).

It is a case of aspergilloma with upper cavitatory lesions. It is mostly seen in diabetics.

Brief history: 

49 year old male patient came to OPD with

Generalized weakness since 2 months cough since 20 days

Patient was apparently asymptomatic 20 days back then he developed cough with expectoriation mucoid in nature(light brown in colour) went to local hospital but not subsided with the treatment and presented to us with cough which is gradually progressing in nature,

Mucopurulent,foulsmelling,non blood stained more in the night

Halitosis - present

Associated with chest tightness

Associated with loss of appetite

Associated with loss of weight from 59 to 40 kgs in 6 months

No history of fever,chestpain,sob,sweating,palpitations

And decreased urineoutput

LOCAL EXAMINATION:

Respiratory system:

Inspection:

Upper respiratory tract:no dns,polyps,turbinate hypertrophy,

Oral cavity: dental stains present

Posterior pharyngeal wall : normal

Lower respiratory tract:

Shape of the chest: symmetrical, and elliptical

Chest expansion equal on both sides

Position of trachea - central

A large hypopigmented patch seen over anterior chestwall

PALPATION:

All inspectory findings are confirmed

No local rise of temperature 

Trachea is central in position

Anteroposterior diameter:28cm

Transverse diameter:24cm

Percussion:resonant (equal in all areas)

Auscultation:

Bilateral air entry present

Non vesicular breath sounds

No added sounds

Vocal resonance:increased in interscapular area

CVS:

S1,S2 present

PERABDOMEN:

soft and nontender

CNS:

no focal neurological deficit

My most are about the third space fluid losses mainly due to renal failure, pleural effusion, anaemia, cirrhosis of liver. This causes volume loss in vascular compartment which may be due to increased hydrostatic pressure, decreased plasma on optic pressure, in some case lymphatics obstruction which clear the interstitial fluid volume. All these causes cause hypoperfusion to the kidney which in return causes RAAS system activation causing volume retention.

https://shiva1d4.blogspot.com/2023/04/35f-with-fever-weakness-sob.html

https://shiva1d4.blogspot.com/2023/04/32m-with-fever-and-pain-abdomen.html

https://shiva1d4.blogspot.com/2023/04/60-year-old-male-resident-with-pedal.html

Thank you.