INTERNAL ASSESSMENT

INTERNAL ASSESSMENT

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13 yr old female

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This is online E log book to discuss our patients health data shared after taking his guardians informed consent form I have been given this case to solve in an attempt to understand topic of" patient clinical data analysis" to develop my competency in reading and comprehensing clinical data including history clinical findings  investigations and come with a diagnosis and treatment plan.  This is a case of 14 yr old female diagnosed with Sickle cell anaemia have multiple admissions for sickle cell crisis  now presented  with chief complaints of        - Joint pains more at night         - Right knee pain since 15 days         - left leg shin pain HOPI Patient was apparently asymptomatic 10 yrs back and diagnosed as Sicke cell anaemia with known history of Abdominal pain, yellowish discoloration of eyes,SOB,fever,dry cough, pleural tap  and she had  blood transfusion 15 times since childho...
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LIVER ABSCESS

This is an online E log book 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 series of inputs from available global online community of experts Fwith an aim to solve those patient's clinical problems with collective current best evidence based inputs.  CHIEF COMPLAINTS                  - Fever since 10 days                 - Loose stools since 5 days                 - Pain abdomen since 5 days HOPI Patient was apparently asymptomatic 10 days ago then he developed fever high grade ,continuous associated with chills and rigor relieved on medication,no nausea ,no vomitings, no burning micturition.Loose stools since 5 days , 3 episodes per day very small volume liquid in consistency no blood stools,no pus in stools,non foul smelling ....
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OSCE LEARNING POINTS

OSCE LEARNING POINTS    1. What is PUO?  Increase in body temperature more than 38.3 °C (101.0 °F) for at least 21 days or three weeks without any established aetiology (cause) after being a thorough clinical evaluation 2.Types of PUO? CLASSICAL PUO: Increase in body temperature for more than 3 weeks and duration of hospital stay is 3 days or 3 outpatient visits without detecting a cause or 1 week of thorough investigations  NOSOCOMIAL PUO: Temperature of more than 38.3 C developing on several occasions in a  Hospitalized patient in whom infection was not manifested or incuabting on admission  with 3 days of investigations including atleast 2 days incubation  of cultures NEUTROPENIC PUO: Temperature of more than 38.3 C developing on several occasions in a patient whose neutrophil count is less than 500/ microlit or expected to fall in 1-2 days . HIV ASSOCIATED PUO:Temperature of more than 38.3 C on several occasions for a period of more than 4 weeks fo...
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