198 Divya Polagoni

OSCE LEARNING POINT: 

December 06,2023 

What eye signs you will look in patient for graves disease?? 

*Graves' ophthalmopathy signs and symptoms include bulging eyes, redness and retracting eyelids. 
*About 30% of people with Graves' disease show some signs and symptoms of Graves' ophthalmopathy
*Dry, gritty, red, or irritated eyes. 
*Puffy eyelids.
*Bags under the eyes. Blurred/double vision. 
*Change of the eyes' appearance (usually staring/bulging) Difficulty moving the eyes. 


What is the cause for fine tremors? 

Hyperthyroidism speeds up the body's metabolism. That can cause many symptoms, such as weight loss, hand tremors, and rapid or irregular heartbeat.
In hyperthyroidism, beta-adrenergic stimulation is incriminated as a mechanism leading to tremor.

What all are the causes for graves disease??
Inflammation of gland 
Autoimmune disorder
Bacterial and Viral infections 
  
What are symptoms for graves disease?
Sweating, tremor,muscle weakness,exophthalmos, nausea, diarrhea, goitre, increased appetite.

How will you treat this case??

*Radioactive iodine therapy 
*Anti- thyroid medication
*Thyroidectomy 

LEARNING POINTS: 

*My learning points around this patient are the importance of taking detailed history from the patient.

*I’ve learnt how a detailed history and examination can lead to the diagnosis.

*How I can help the patient to get back to his daily routine. 

*I’ve learnt how does graves disease  can lead to various other complications.

*I've learnt how to differentiate hyperthyroidism nd hypothyroidism based on signs and symptoms. 

*I’ve learnt how to approach graves disease  in terms of management.

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Divya Polagoni  Roll no :198 CHIEF COMPLAINTS:  * 45 yr old male came to gen medicine department with chief complaints of tremors, numbness in left lower and upper limb, dryness of mouth , loss of control , abdominal pain. HISTORY OF PRESENT ILLNESS: He was apparently asymptomatic 6 months back. He used to suffer from abdominal pain occassionally ( when he takes spicy food). He consulted doctor and took medicine. He got tremors on thursday morning 7:30 am as he did not consume alcohol. Tremors disappeared and became normal after consuming alcohol. He then took alcohol on friday and no symptoms seen. On saturday, he did not consume alcohol and he developed tremors, dryness of mouth, loss of control. He immediately went to RMP and took 2 injections. The symptoms did not diasappear. He then went to a private hospital. Ecg, RBS ,MRI,lipid profile tests were done and are completely normal. He was then reffered to KIMS hospital.  Past illness: No h/o DM HTN TB epilepsy asthma chromosomal abn
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A 29year old male with Thyroiditis with Thyrotoxicos December 05,2023 This is an a online e log book to discuss our patient's de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts intending to solve those patient's clinical problem with the collective current best evidence-based input. This E-log also reflects my patient centered online learning portfolio and your valuable inputs. I have been given this case to solve 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. The patient/ attender was informed the purpose of the information being acquired. An informed consent was taken from patient/ attender and there is omi
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