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  60 year old male patient , who works as a daily wage worker hailing from Palem presented to the hospital with- • reduced micturition and defecation since 2 months. • burning sensation on micturition since 2 months. HISTORY OF PRESENT ILLNESS • Patient was apparently asymptomatic 2 month  back. • The patient is a retired coolie who does work in the day. • He wakes up at 6am, roams around his village,  and he take rest at around 10pm. • 2 weeks after Dusshera (2 months back), patient suffered with a dizziness and cough which he attributes to "cold". • Patient was taken to an ENT specialist who ruled him clear of any problem. • The same day, the patient noticed an acute decrease in his defecation and micturition. • When patient was taken to the hospital in Nakrekal where he was diagnosed with Renal failure.  • He was put on Maintainance Hemodialysis since then. • Patient recollects that after 5 days of dialysis, patient's micturition and defecation was somewhat restored. 
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FINAL SHORT CASE

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CHIEF COMPLAINT:                      A 60 year old male patient driver by occupation came to  causality with the chief complaints of -Pedal oedema since 15 days.   -Vomitings since 1 week -SOB since 5 days.                                               -Fever,cough since 5 days. -Decreased urine output since 3 days -He is a known case of chronic renal failure and he is on hemodialysis and he underwent (4) sessions of hemodialysis. HISTORY OF PRESENT ILLNESS ; -Patient was apparently asymptomatic 15 days back and he is completely normal and he was able to do his regular routine work.   -But 15 days back he developed oedema in his lower limb which is extended up to ankle which is pitting type -fever which is continuous associated with cough and vomiting  since 5days.vomiting of one episode which is non projectile - Cough with sputum which  is red in colour and reduced after medication. -SOB of grade 4 since 5 days -Patient had underwent 7 sessions of hemodialysis till date. PAST HISTORY
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FINAL (CASE HISTORY)

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 A 50 year male farmer ,manual labourer,brought  to casualty with h/o altered sensorium  H/o fever since 5 days. HISTORY OF PRESENTING ILLNESS - Patient was apparently asymptomatic 5 days ago,then he developed fever which is high grade,No diurnal variation, associated with chills. -No h/o cough and GE symptoms.  -Attenders tells h/o stoppage of  OHA for 3days, h/o decreased intake of food as he has fever. -H/o altered sensorium  -Irrelevant talk,not recognising attenders since this morning . -Able to move all four limbs,No h/o vomitings, head ache, seizures. -Took him to nalgonda hospital SHIFTED HERE FOR FURTHUR MANAGEMENT.  PAST HISTORY -  -H/o TB 2YRS back used ATT for 6 months. -Diagnosed as Type -2 Diabetes mellitus on OHA 1 YR back -No H/O HTN,CVA,CAD,COVID-19. PERSONAL HISTORY  -DIET - MIXED, -APPETITE -NORMAL , -BOWEL MOVEMENT - REGULAR ,  -BLADDER MOVEMENTS - REGULAR, -ADDICTIONS-H/O  SMOKING 30yrs ago(1 pack per day)-  -ALCOHOL-REGULAR INTAKE OF 180ML  SINCE 30YRS,STOPPED SIN
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PRE FINAL ANSWER SHEET

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  1.Define Heart failure, etiology, and clinical features of heart failure? How do we diagnosis heart failure clinically, physical examination and various modalities used in diagnosis of heart failure. Write a brief note of treatment of heart failure 2 .Define Cirrhosis of liver. Etiopathology of cirrhosis. Write a brief note on clinical features, diagnosis and treatment of cirrhosis of liver. 3.Elaborate on clinical features and diagnostic modalities in diagnosis of renal calculi 4.Etiology of pleural effusion diagnostic criteria of pleural effusion? 5.diagnosis and treatment of dengue fever?   6.clinical features and diagnosis of peptic ulcer disease 8.treatment of abdominal TB? 9.etiology and treatment of pnuemonia? 10.complications of dialysis ? 11.Ascitic fluid analysis 12.Proton pump inhibitors. 13.after load reducing agents in heart   14.treatment of urinary tract infection 15.diiferential diagnosis of fever with rash 16.insulin therapy in dm  17.antihypertensive drugs in chroni
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