General Medicine

  Hello everyone..! I am SrideviTripuraneni,an intern posted in medicine department and one of the most important terms of getting internship completion is to complete mu log book with my online log of what I learn during the course of my duties.    Here we discuss our individual patient’s problems through series of inputs from available global online community of experts with an aim to solve these patient’s clinical problems with collective current best evidence based inputs. This e-log also reflects my patient-centered online learning protfolio and your valuable inputs on comment box is welcomed. Here is the case i have seen: A 45 year old male came to the hospital with the chief complaints of pain in the left foot 2nd toe since 4 days , fever since 4 days  C/o burning feet since 2 months C/o burning micturition since 2 months   History of present illness: Pt was apparently asymptotic 10 days back then had a history of trauma to left 2nd toe where there was a bleb formation and got r

                         SrideviTripuraneni                              Roll no.138 1)Anatomical diagnosis -? Renal -Glomerulosclerosis                                               Etiological diagnosis -  ?? Nephrotic syndrome secondary to the diabetic nephropathy or CKD.      2)Reasons for I) Azotemia : impaired renal excretion of urea and creatinine secondary to CKD.  II) Anemia : decreased erythropoietin.  III) Hypoalbunemia: capillary basement membrane and podocytes damage.  IV)  acidosis: acidification of urine is lost.                                       3) Rationale : syp potchlor was given because of the hypokalemia.. Inj. NaHCO3 was given because of metabolic acidosis ..Insulin and antihypertensives are given because known case of DM and HTN. Orofer XT was given because of anemia.. Inj. Lasix was given to decrease her volume overload. Spironolactone was given it was a potassium sparing diuretic.Calcium was given to the patient  because of hypocalcemia secondary to CKD. In