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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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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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INTERNAL ASSESSMENT SEPTEMBER

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Internal Assessment July 2023

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1) A 33 YR man,  FLOWER POT MAKER BY OCCUPATION, RESIDENT OF BONAGIRI, CAME TO OPD WITH  CHIEF COMPLAINT of  Abnormal movements in his upper limbs since 5 years and difficulty in walking since 5 years. The patient is apparently  asymptomatic 5 years back then he started developing abnormal  involuntary movements in his upper limbs since 5 years. The movements were noticed during rest and also while walking. He haS difficulty in walking initiation and once he walks, he walks with short sride length and freezes during turning.There is also decreased swinging of hands while walking. Also noticed difficultly in speaking. https://101pallirakesh. blogspot.com/ 1) LAQ 10 marks  Approach to anatomic and etiologic differential diagnosis and therapeutic considerations in persons with a movement disorder  2) SAQ 5 marks  Etiology, diagnosis and therapy of Parkinson's disease  3) MCQ 5 marks :  Triad of Parkinson's disease consists of all except : a) Tremor  b) Rigidity  c) Spasticity d) B
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