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Showing posts from December, 2023

PREFINAL Osce and Learning points

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Blog link :    https://divyasreevanka.blogspot.com/2023/12/60-year-old-female-with-ckd-on.html OSCE QUESTIONS : 1) Causes of left heart failure  Common causes are : Acute MI especially if involves  left ventricle, chronic hypertension, dysrhythmias especially tachydysrrthithmias                         2) Side effects of furosemide https://www.ncbi.nlm.nih.gov/books/NBK499921/#:~:text=Intravenous%20furosemide%20is%20twice%20as,torsemide%20%3D%201%20mg%20of%20bumetanide 3) preload and afterload Preload : Preload is volume of blood received by the heart. Basically preload is stretch.It is the ventricular stretch at the end of diastole. Occurrence : during diastole Depends on : The amount of ventricular filling. Preload is a volume. Affecting factors : venous blood pressure and the rate of  venous return.  Afterload :  Afterload is the pressure that the Chambers of the heart must generate in order to eject blood out of heart. Occurrence : during systole Depends on :The arterial blood pres

60 year old female with CKD on maintenance haemodialysis

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This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings investigations and come up with diagnosis and treatment plan. A 60 year old female resident of suryapet farmer by occupation came to the OPD with CHIEF COMPLAINTS : Swelling of both legs  since 20 days Breathlessness since 2 days  HISTORY OF PRESENT ILLNESS Patient was app