Kims PG medicine exam-1

  1)Lumbar Puncture Getting training from seniors(Dr Sushmitha & Dr Divya) for LP Procedure Lumbar Puncture Preparation Lumbar Puncture   Lumbar Puncture:High opening CSF pressure Guiding my Junior for  LP procedure

  CHEIF COMPLAINTS 40yr female farmer by occupation came with complaint of  Pain in the both hips (Since 6 months) Pain in the both hands Finger joints on & off (Since 6months) HISTORY OF PRESENT ILLNES Patient was apparently alright 6months back,then she developed pain in the both hip regions which is insidious onset,gradually progressive,aggrevated on walking,getting up from sitting posture,Pain relived on taking medications. Associated with Pains in the multiple small joints of both hands on and off.No history of early morning stiffness,heel pain. PAST HISTORY Patient had history of multiple hospital  admissions due to hypokalemic paralysis over past 3years 1st episode :-In 2020,Pt developed weakness of right lower limb, taken to hospital found out to be potassium low, after correction, she recovered  Asymptomatic between 2nd episode :-In NOV 2021,Paraperesis,Potassium was low,Recovered after correction 3rd episode : In May 2022,Quadriparesis,Potassium was low,Intubated and conn

CHEIF COMPLAINTS  55yr male Tiles construction worker came with complaint of Generalised weakness :- 2 months                          Fever  :- 2 months                  Dry cough  :-2 months                         HISTORY OF PRESENT ILLNESS  Patient was apparently alright till 2months back then he had insidious onset of fever, intermittent, relived on taking medications,not associated with chills and rigors. Fever is associated with generalised weakness(not able to perform his previous routine job works) and dry cough(which is insidious onset, intermittent,relived on taking medication, no aggravating factors, not associated with positional or seasonal variation) History of weight loss, loss of appetite present. No history of coughing of blood, chest pain, palpitations,swelling of lower limbs, facial puffiness, decreased urine output PAST HISTORY History of pulmonary tuberculosis 25years back,used ATT for 6months.No history of interventional procedures done during that period. Not a

 30 /F,homemaker,unmarried, hailing from chityal, who completed her bsc botany came with  COMPLAINTS :-  Lethargy-----> since 6 months HISTORY OF PRESENT ILLNESS : - Patient was apparently asymptomatic 6 months back then she had insidious onset of lethargy,  easy  fatiguability  on doing daily chores like cooking, cleaning the house. No history of any  fever, cough,Loss of appetitie,weight loss,chest pain, palpitations,pedal edema No menstural abnormalities PAST HISTORY :- At her 17years of age(in year 2010), One afternoon while bathing, she suddenly developed weakness  of right upper limb  and lower limb, along with deviation of mouth to left side  upon which she made  sounds , her   mother who was nearby came to her aid ,and she was taken to hospital in nalgonda  within an  hour,and referred to gandhi hospital where she was admitted for 1month,during which her  speech returned.She was able to walk without support after 1month,but still has limp on walking. Weakness of the right  u