Pre final paper 2

 














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14 y female child with fever and swelling of left upper limb and right lower limb k/c/o SCA

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 25/7/2023. 14 year female child who is k/c/o sickle cell anemia came with c/o fever and swelling of left upper limb and right lower limb associated with pain since 3 days  Fever which is of high grade not associated with chills and rigors , cold ,cough, sore throat, chest pain , palpitations,sweating,abdominal pain,vomitings,diarrhoea,decreased urine output . No h/o hematuria , melena,bleeding gums,petechia,menorrhagia . HISTORY OF PRESENTING ILLNESS: Patient was apparently asymptomatic 11 years ago (1/4/2012) when she was 3 years old she was admitted in the hospital with c/o fever , cough, vomitings she was diagnosed to have sickle cell anemia (Hb electrophoresis was done) and was given blood transfusion and treated with Inj ampicillin and folic acid  2. On 23/9/14  She was taken to the hospital with complaints of fever, cough ,cold since 1 week and diagnosed with bronchopneumonia ( chest x ray showed left lower lobe consolidation). She was treated with Inj Augment...
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46 year old male with spasm of upper limbs

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  46 year old male from chityala came with   c/o spasm of fingers of upper limbs with tremors since 3 days , excessive sweating , calf muscle pain and generalised weakness since 3 days .  History of presenting illness: Patient was apparently normal 10 years ago then he had severe stomach pain and vomitings for which he was admitted to the hospital and was diagnosed to have pancreatitis, he underwent surgery For that and was discharged.After 5 years he went to hospital with complaints of weight loss and weakness,there he was diagnosed with diabetes and was put on oral hypoglycemic drugs , his sugar levels weren’t controlled so he was shifted to insulin . (Past 6 years he is on insulin ) . 4 months ago he had an episode of seizures associated with up rolling of upballs which lasted for one minute, 5 episodes occurred in 30 minutes and in between each episode he had no memory of what had happened. He was admitted in KIMS hospital and was discharged after 5 days . He also has...
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A 65 year old male with SOB

 1 st August,2022. A 65 year old male patient from Gundrampally village, Chityala district who used to be a toddy climber by occupation came to the casuality with C/o Shortness of breath since 3 days Associated symptoms are  Weakness in left upper limb and lower limb since 8 days Difficulty in walking since 8 days Involuntary defecation and micturition since 5 days History of presenting illness As explained by the patients' younger son Patient was apparently asymptomatic 10 years back then one day early in the morning while waking up he noticed weakness in the left upper limb and lower limb and couldn't support himself properly. 2 days later he started using Ayurvedic medicine for the weakness, which progressively improved and he got completely alright within a month and got back to his daily routine Patient had a normal life style until 8 days back.  8 days back at 12 am patient woke up to micturate and noticed that he is having a similar weakness in the left upper and l...
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