CASE 1: 1) Patient develops hypoalbuminemia due to liver pathology as liver helps in albumin synthesis. Oncotic pressure is reduced leading to accumulation of fluid. So patient developed Ascites due to loss of starling forces 2) a) The pedal edema may also be explained by the hypoalbunemia hypothesis. But it can also be explained in terms of increased pressure in the abdomen in gross ascitis which may have caused obstruction to the lymphatic vessels and causing pedal edema (this is mostly supported for unilateral pedal edema) b) in case of pedal edema there is stretching of skin and cracking up this may alter the defence mechanisms of skin. pathogens lodge and may develop infections, cellulitis of the leg. c) At the same time due to increased stretching of the skin the upper epidermis gets separated and leads to accumulation of fluid there, which is the reason for blebs. d) When there is excessive stretching there will be more pressure which may lead to pr...
This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome. A 54 year old Toddy tree climber came to opd with chief complaints of 1. Swelling of both the legs since 15 days 2. chest pain since 10days 3. Facial puffiness since 10days 4. Difficulty in breathing since 7days Patient was apparently asymptomatic 15days back then he developed bilateral pitting type of pedal edema extending Upto knees. He had on and off symptoms of Chest discomfort and pain since 10days. He also developed facial puffiness 10 days back which t...
1) "55 year old male patient came with the complaints of Chest pain since 3 days Abdominal distension since 3 days Abdominal pain since 3 days and decreased urine output since 3days and not passed stools since 3days. https://sreejaboga.blogspot. com/2020/11/is-online-e-log- book-to-discuss-our.html?m=1 Question 1) pain in the epigastric region differentials Epigastric Biliary: cholecystitis, cholelithiasis, cholangitis Cardiac: myocardial infarction, pericarditis Gastric: esophagitis, gastritis, peptic ulcer Pancreatic: mass, pancreatitis Vascular: aortic dissection, mesenteric ischemia p971.html Gall stones : This occurs at the level of the sphincter of Oddi, a round muscle located at the opening of the bile duct into the small intestine. If a stone from the gallbladder should travel down the common bile duct and get stuck at the sphincter, it blocks outflow of all material from the liver and pancreas. This results in inflammation of the pancreas t...
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