1st Internal Examination

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23y old female with facial puffiness and pedal edema

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  23 year old female resident of vutikodu farmer by occupation came to OPD with chief complaints : Facial puffiness (on and off) since 5 months. Bilateral Pedal edema (on and off) since 5 months  Shortness of breath (grade 2) since 5 months. Fatigue since 5 months.  History of presenting Illness: Patient was apparently asymptomatic 5 months ago.Then she developed facial puffiness which was insidious in onset and gradually progressive in nature ,aggrevated while working in farm and relieved on medications . Bilateral Pedal edema since 5 months which was insidious in onset, gradually progressive in nature, aggrevated while working in farm and relieved on medications.It is pitting type. Shortness of breath (Grade 2) according to NYHA classification since 4 months. Sequence of events:  Five months ago, patient developed facial puffiness, bilateral Pedal edema ,fever with chills and rigor .So she visited a near by hospital,took medication,but symptoms didn't relieve. La...
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76 year old female with hemiballismus secondary to uncontrolled sugars

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27 yr old male presented with stomach pain

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 27yr old male resident of vellanki Mason by occupation came with chief complaints of stomach pain since 2 days An episode of vomiting just before presentation HOPI: Patient was apparently asymptomatic 3days ago then he developed stomach pain in epigastric area which is insidious in onset pricking and shooting type of pain radiating to back (lumbar region) gradually progressive in nature aggregated on not having food and no relieving factors 7-8 episodes of non projectile and non bilious vomiting History of fever 10days ago  History of weight loss, loss of appetite, insomnia, fatigue  No complaints of chest pain, palpitations, SOB, headache, burning micturition,loose stools, giddiness SEQUENCE OF EVENTS PAST HISTORY He is known alcoholic since 5 years with a daily intake of 160ml No history of DM,TB, ASTHMA,HTN, EPILEPSY, THYROID DISORDERS, ALLERGIES  FAMILY HISTORY No relevant family history PERSONAL HISTORY  Diet mixed  Appetite reduced  Bowel and bl...
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