Vavilikolanu Sowmya

FINAL PRACTICAL- SHORT CASE HT NO: 1701006192 A 55 yr old female who is house maid by occupation came with chief complaints of Head ache since 20 days Fever since 5 days Neck stiffness since 5 days HISTORY OF PRESENTING ILLNESS :      Patient was apparently asymptomatic 20 days back then she developed headache which was insidious onset, gradually progressive, not relieved on medications ,the headache aggravated 5 days back In spite of taking medication. No aggravating factors Fever which was insidious onset since,intermittent,not relieved on medication.Not associated with chills / rigors,associated with neck stiffness  One episode of vomiting food particles 3 days ago,non projectile, non bilious, , non blood stained. No h/o of cold and cough  No h/o of loose stools  No h/o of abdominal pain No h/o of breathlessness, PND , orthopnoea No h/o of burning micturition, increased frequency of micturition.  PAST HISTORY : No history of similar complaints in the past. 7 yrs back she gave histo

FINAL PRACTICAL- LONG CASE : HT NO: 1701006192 A 65 year old male, resident of Bhongiri and a Toddy tree climber by occupation, came to the OPD with chief complaints of: Loss of appetite since one week Swelling of the lower limbs since 4 days Decreased urine output since 4 days Daily routine: Patient is a toddy tree climber, wakes up early in the morning at around 5:30 am and goes for work after having breakfast. He comes back for lunch and again goes back to work. He has stopped working  4 years ago because of backpain. HISTORY OF PRESENTING ILLNESS : On Day 1: Patient was apparently asymptomatic 4 years ago, when he developed knee pains and generalized weakness , for which he went to a local hospital, and was given some medication. The pains occured on and off for about 3 years and most recently patient complained of backache 2 months ago radiating towards the right lower limb,   and hence MRI SPINE was taken, which showed L4 - L5 spondylolisthesis with mild sclerosis, and was ad