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General medicine case study Roll no 43 I was given a paraperesis    Cheif complaints Difficulty in climbing stairs since one month Bilateral lower limb weakness since one month Difficulty in holding cheppal Wasting and thinning of lower limb muscles more than upper limb No history showing sensory involvement  No history showing involuntary movements  Cerebral invovment based history was not there So my diffrentials concised to UMN or LMN lesion On examination On examination we find Normal grneral examination Hemogram , serum electrolysis , other lab investigations wer normal Thyroid tests were normal  CNS examination showed Atophy Hypotonia Absent deep tendon reflex Babinski sign negative  This confines my diagnosis to LMN lesion Lesion of LMN can be located at four places on its pathway Anterior horn cell Peripheral nerve NMJ Muscle (myopathy) To rule out Anterior horn cell disease and peripheral neuropathy , evaluation of conduction velocity (NCV), histological findings , biochemica

General medicine  Paraparesis case  Roll no 43 Cheif complaints Bilateral lower limb weakness since 20 days  Started proximal later progressed to bilateral distal region Bilateral edema which is non pitting  Difficulty in squatting and getting up Difficulty in wearing chepals NO H/O DIFFICULTY IN COMBING HAIR , BUTTONING AND UNBUTTONING SHIRT NO H/O CRANIAL NERVE INVOLVEMENT                         Neurological weakness 1. Upper motor neuron 2. Basal ganglia and cerebellum 3. Lower motor neurons  Other causes of weakness might be  Systemic  Drug induced Vitamin deficiency  Autoimmune diseases Thyroid condition On examination  Patient is coherent conscious and cooperative   general examination was normal Higher mental status is normal Cranial nerve functions are intact Motor system Tone normal Power slightly decreased 4/5 in both lower limb Reflexes are absent in both lower limbs Sensory system was intact  No specific signs of meninges or cerebellar Lab investigation  Blood  Urine  Ecg

18yr old male with complaints of "DIFFICULTY IN WALKING I've 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 a diagnosis and treatment plan.  Following is my analysis of this patient's problem:  chief complaints of the patient. The problems in order of priority I found are  1) difficulty in walking since 1 month 2) bilateral lower limb weakness since 1month 3)pain in lower limb calf muscles since 1 month 4)fever since 1 week Reasons for each problem in detail .  A.Difficulty in walking and weakness of lower limbs                  Onset :sudden            Duration.:since 1 month            Site:. Both legs below the knee i.e near calf             Associated complaints:              H/o difficulty in standing from sitting                              position.             H/

GENERAL  MEDICINE  E-LOG BOOK  Roll no:  43  DEMOGRAPHIC DETAILS: A 42year old female patient,came  with MULTIPLE HEALTH EVENTS SINCE BIRTH The patient..  falls frequently to the left. Her left foot and hand started to worsen. She has poor stress response Rashes on face around 2 to 4 episodes per year . Developed swelling, hair loss and fatigue. She has left jaw pain radiating to the face. She has dyspnea, oliguria .develops swelling when ingesting most of the foods, or smoke.Finds herself to be slim morning and appears to be a pregnant in the noon.  Develops weakness on exertion. Craves for salt and fats. Ingests 2-4 tbs of salt when she feels sick.  Past history As an infant-  jaundice at birth,tongue tie and upper lip tie, has less sleep around 2 or 4 hrs a day ,  vomits food taken apart from water, developed generalised edema 2 year old-  Developed severe headaches 3year old-  ex cess hair growth on face, neck, toes and legs ,sleep duration continued to be the same, ate nothing alm