Internship medicine posting

                                                  1)Anatomical diagnosis -? Glomerulosclerosis                                                                        Etiological diagnosis -  ?? Nephrotic syndrome secondary to the diabetic nephropathy or CKD.      2)Reasons for I) Azotemia : impaired renal excretion of urea and creatinine secondary to CKD.  II) Anemia : decreased erythropoietin.  III) Hypoalbunemia: capillary basement membrane and podocytes damage.  IV)  acidosis: acidification of urine is lost.                                       3) Rationale : syp potchlor was given because of the hypokalemia.. Inj. NaHCO3 was given because of metabolic acidosis ..Insulin and antihypertensives are given because known case of DM and HTN. Orofer XT was given because of anemia.. Inj. Lasix was given to decrease her volume overload. Spironolactone was given it was a potassium sparing diuretic.Calcium was given to the patient  because of hypocalcemia secondary to CKD. Indications of NaHC

 This is an online elog book to discuss our patients de identified health data shared after taking his/her guardian signed informed consent. Here we discuss our individual patient's problems through series of inputs from avialable global online community of experts with an aim to solve those patients 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 in comments below. A 16 year old female who is a student by occupation came to the old with complaints of headache since 3 months on left temporal region pulsating type radiating to parietal and occipital region,progressive type Patient was apparently asymptomatic 1 month back and then she developed headache in left temporal region and radiating to occipital region .Headache is not associated with fever,cold,cough,associated with decreased appetite and headache relieved on medication. Patient now presented with complai