1st internal assesment

Q2)what is myxedema coma ?describe its clinical features, diagnosis and treatment of myxedema coma.
diagnosis:blood samples sent for T3 T4 TSH levels .in hypothyroidism T3 T4 levels are decreased  TSH levels are increased.
Adrenal insuffiency should be ruled out through the tests.
Hypothermia is a feature of myxedema coma and helps as a clinical diagnostic point.
Treatment: thyroxine 300ug is given in infusion over 5 to 10min followed by 100ug every day till the patient is alert and normal.
Hydrocortisone 100ug is given if there is adrenal insuffiency .hydrocortisone is given 8hrly till the levels are increased and normal.

Q1)define bone density, how it is measured?what are the causes ,clinical features ,diagnosis and management of osteoporosis
diagnosis: dexa scan for measurement of  bone density.
Treatment:vitamin d and calcium supplementation 3000_6000 IU of vitamin d can be given daily.
Selective estrogen receptor modulator(serm)
Raloxifen can be used instead of HRT
Terparatide can be given
Surgical treatment:
If patient presents with a fracture first treat fracture and then give medical management to prevent recurrence.
 
Q6)describe about megaloblastic anemia.

Prevention of megaloblastic anemia 
Avoid alcohol.
Adequate intake of food containing colic acid and vitamin B12.
Take vit B supplements if on medications that reduce acid secretion.


Q8)approach to acute pancreatitis.


Investigations:
USG: swollen pancreas
X ray : pleural effusion                                          In  recurrent and chronic pancreatitis  calcium  deposits in pancreas due to fat necrosis.
Treatment:
Avoid  alcohol
If  pancreatitis is due to gall stones cholecyestomy.
In USG if  gall stones are seen cholecystectomy is done. Prophylactically not to cause single episode of pancreatitis.

Q7)what are the causes, pathogenesis and differential diagnosis of ascites.     http://saichennuru.blogspot.com/2021/09/45-year-old-male-patient-with-back-pain.html(


Q5) causes, diagnosis, treatment of atrial fibrillation




Q4) how do you clinically localise the anatomical level of lesion in spinal cord diseases.

http://sowmya9.blogspot.com/2021/08/21-year-old-with.html(2nd


Q9)differences between UMN and LMN.

Q10)indications of hemodialysis 

resistant hyperkalemia 

-urea >180mg/dl, creatinine >8 mg/dl.

-refractory fluid overload. 

- ckd stage -5

I remix symptoms like altered mental status,pruritis

Q11)role of sucralfate in treatment of corrosive gastritis 

https://aishwaryagannoji35.blogspot.com/2021/09/45-year-old-female-with-vomiting-since.html

Sucralfate froms a layer in gastric mucosa and protects it from acid damage.

Sucralfate coagulates protein and forms a layer  and prevents erosion of mucosa.

It is given prophylactically to all post operative patients to prevent gastritis.

Q12) mention renal manifestations of snake bite

https://achalram1512.blogspot.com/2021/08/admission-65-year-old-male-from.html(

Q13)causes of portal hypertension 


Q14) clinical features of Down syndrome 


Q15) post streptococcal glomerulonephritis complications

Post streptococcal glomerulonephritis complications:

Pulmonary edema

Hypertensive encephalopathy

Q16) causes of cervical myelopathy 

Disc prolapse
Cervical spondylytis
Potts spine
Fracture of cervical vertebrae
Spinal cord lesions in cervical region

Q3) what is diagnostic approach of young onset hypertension and it’s treatment.







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