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29 year old with bilateral lower limb pain

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  I am Soumya 9th semester student . This is an e-LOG depicting patient's de-identified data centered approach for learning medicine. This log has been created after taking consent from patient and his family. Here we discuss about patient's problems with a series of inputs with an aim to solve them CASE SCENARIO 29 yr man from Miryalaguda ,a agriculture coordinator K/C/O CKD came to casualty with cheif complaints of Bilateral lower limb pain since 20 days HISTORY OF PRESENT ILLNESS Patient was apparently normal 3 years ago then developed pain in right lower abdomen diagnosed to have renal stones of size 4mm to 6mm and also raised creatinine upto 6 for which he had medication and both problem of stones and creatinine came down Then after 6 months he had bilateral ankle pain ,which is pricking type and precipitated by heavy work for which we visited a local doctor where he found rised uric acid levels , also adviced decrease protien rich diet along with medication  also had hist
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OSCE questions

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https://soumyamenda80.blogspot.com/2023/11/29-year-old-with-bilateral-lower-limb.html 1.How NSAID abuse effects on kidney leading to renal injury and How long exposure and dosage can cause injury The main mechanism of NSAID action is cyclooxygenase (COX) enzyme inhibition, interfering on arachidonic acid conversion into E2 prostaglandins E2, prostacyclins and thromboxanes. Within the kidneys, prostaglandins act as vasodilators, increasing renal perfusion. This vasodilatation is a counter regulation of mechanisms, such as the renin-angiotensin-aldosterone system works and that of the sympathetic nervous system, culminating with compensation to ensure adequate flow to the organ. NSAIDs inhibit this mechanism and can lead to acute kidney injury (AKI). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534025/ 2.What other drugs or treatment modalities could be possible other than NSAIDs for pain? He had history of Rat poison ,does it have any significance in etiopathogenesis of the
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18 Y FEMALE WITH WEAKNESS IN LOWER LIMBS

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Soumya Menda 3rd sem 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. I have been given this case in an attempt to understand the topic of  " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan. Case scenario: A 18 year old female came to causality on 8/7/21 with Cheif complaints of Weakness in both lowerlimbs.  Unable to stand and walk.   History of present illness: 18 year ol
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