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Showing posts from December, 2023

Pre final OSCE and Learning points

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  The case allotted to me one day before the exam is presented in the following log which can be found here https://126singareddymanasa.blogspot.com/2023/12/a-65-year-old-male-with-dka-with.html OSCE 1) Can diabetes cause Fatty liver, if yes how?      Yes, Diabetes can cause fatty liver.  Non-alcoholic fatty liver disease (NAFLD) is highly prevalent in type 2 diabetes mellitus.  The pathogenesis of NAFLD is not yet fully understood, but insulin resistance appears to be a critical contributing factor with obesity as the most common cause of the insulin resistant. As body fat stores expand with  excess calories and progressive obesity, alterations in lipid metabolism along with inflammation in adipose tissue and ectopic sites of fat deposition lead to insulin resistance. Insulin resistance leads to increased its accumulation in body. This excess insulin increases lipolysis and increases the production of free fatty acids. The surplus amount of fatty acids cause an excess production of tr

A 65 year old male with DKA with community and acquired pneumonia and pre renal AKI

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This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. Consent: An informed consent has been taken from the patient in the presence of the family attenders and other witnesses as well and the document has been conserved securely for future references   A 65 year old male was brought to casualty with CHIEF COMPLAINTS Fever since 4 days Breathlessness since 1 day HISTORY OF PRESENTING ILLNESS   Patient was apparently asymptomatic 10 days back when he developed cold and cough with expectoration which is greenish and mucoid. Now the expectoration has de