Kims PG medicine exam-1

  https://medicinedepartment.blogspot.com/2021/03/medicine-paper-for-march-2021-bimonthly.html?m=1 Answer all questions                                                    Max Marks: 100 (10 marks for each  answer) . 1)  Please go through the patient data in the links below and answer the following questions: https://ashakiran923.blogspot.com/2021/03/60-years-old-male-fever-under-evaluation.html?m=1 a) . What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings?How specific is his dilated superficial Abdominal vein in making diagnosis? A) 60 yr old male with complaints of fever and sob  Pt is having ascitis and splenomegaly which indicates portal htn ( Hepatic cause of portal hypertension probably micro nodular cirrhosis ) ,as there is gross ascitis and mild splenomegaly . Fever and Sob can be due to underlying pneumonia of left lower lobe .( Cxr picture isn't available here). Pt also has AKI on 

 51yr male Tractor driver by occupation was apparently alright 3months back One day while he was returning back from field with a Water pump generator on bike(he was under the influence of alcohol),lost his control,fell on the ground.He got sustained injuries to right lowerlimb ,taken to private hospital in nalgonda,surgery(ORIF + Distal Tibia,fibula plating)was done.After 15days he started walking with walker,There after 1week he walked with a stick,After that 20day’s he started walking without support.patient is having pus discharge from surgical site after 1month,he was diagnosed to be having high sugars(so his injury is not healing-as said by local doctors),he was having surgical site dressing for every 5days.Started taking Glimepiride(2mg)+Metformin(500mg) daily OD till 7day’s,Later started taking xBD From 1month pt had insidious onset of dragging type of pain  initially in  right hip region later on to left hip region till knee.After 1week of pain over B/L lower limbs,Pt develope