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   July assessment  Q1 1.PULMONOLOGY   PATIENT DETAILS: https://soumyanadella128eloggm.blogspot.com/2021/05/32-year-old-male-with-viral-pneumonia.html REVIEW: As patient was having episodes of SOB she was put on BIPAP to increase Spo2 levels .      Patient was having electrolyte imbalance like hyponatremia hypokalemia hyperbilirubinemia  . This is because of usage of steroids and diuretics . 2.NEUROLOGY   PATIENT DETAILS: https://143vibhahegde.blogspot.com/2021/05/wernickes-encephalopathy.html Etiology is stated accurately i.e., alcohol withdrawal and symptomatology stands the same [seizures, tremors, restlessness] Thiamine, lorazepam, Kcl are standard medication in my view Alcohol withdrawal symptoms will fit the best It is right decision to give thiamine since it is majorly involved in ATP and NADH production dehydration is the only probable cause for dehydration in my view The mentioned reason is appropriate i.e., alcohol decreases iron absorption and bleeding ulcer is cause

  A 70 YEAR OLD MALE WITH SOB AND SWELLING, DISCHARGE FROM RT. LOWER LIMB( CELLULITIS)  Chief complaint : • Altered sensorium , since 2 days • SOB grade IV , since 5 days • Pedal edema grade III, since 7 days • Rt. Lower limb cellulitis, since 7 days History of presenting illness: • A 70 yr old male, farmer by occupation, was apparently asymptomatic 2 yrs back.  • Had h/o CVA 2 yrs back and for which he used medications for 4 months, and stopped.  • k/c/o HTN since 2 yrs and is on regular medication • k/c/o CKD since 2 yrs and is on conservative management •1 1/2  yr back, had h/o trauma - Lt. femur • 1 yr back - Lt. arm # , for which casting was done • 15 days back, he had h/o trauma to Rt. Lower limb which gradually progressed to rt. Lower limb cellulitis • c/o pedal edema grade - III, pitting type, relieved on medication • c/o SOB grade II-III, progressed to grade IV • H/O chest pain and chest tightness • No c/o palpitations, syncopal attacks • decreased urine output + , facial puff