G.VAMSI KRISHNA

Case History and Clinical Findings: 69 year old male chronic smoker since 40years and alcoholic since 20 years known case of hypertension sine 5 years was apparently asymptomatic 5 years back until he had sudden onset chest pain and SOB for which he was taken to a hospital in hyderabad where he was told to be having some heart problem and symptomatic treatment was given (no records are available). patient was completely asymptomatic from then in the past 5 years until last night when he had low grade fever and 2 episodes of vomiting after alcohol intake.  From 16/6/21 morning he had pain abdomen,abdominal distention ,SOB and drowsiness.  Patient came to the casuality in a state of drowsiness with pain abdomen ,distension ,SOB and generalised weakness.  O\E: Pt drowsy but arousable , coherent and cooperative  JVP raised PR: 78bpm  BP:110/70 mm hg  SpO2:98% on RA  CVS: s1,s2heard  RS:BAE + , NVBS , Fine crepts + in Right IAA & ISA P/A: soft,distended  CNS: NFND 30 min later GCS worse

BIMONTHLY INTERNAL  ASSESSMENT- APRIL Clinical problem solving  Medical terminologies familiarity including areas of anatomy, physiology, pathology, ML, AI  Empathy and medical humanities  Current EBM strategies for managing diagnostic and therapeutic uncertainty  Section 1) Please go through the patient data in the links below and answer the following questions: Anatomic and physiologic localization of symptomatology  In patient's own voice: Patient 1 "I suffered from bad cramps and loose stool movements – and not the usual stomach cramps, it felt like someone was trying to tear out my insides. On top of that, I was constantly bloated, suffered from bad mouth ulcers, mood swings, hot and cold chills, weight loss, and the dreaded haemorrhoids. It was only in the last year that I started noticing a lot of blood in my stools (lovely I know). My whole body was in pain, from my joints to my muscles, and to my mental state. This led to me becoming quite depressed and anxious, makin