second internal examination

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A 32 year ald male

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 complaints: Patient complaining of decreased appetite since 10 days , fever since 10 days Vomiting since 7 days associated with pain in abdomen, History excessive alcohol intake since 1 month , aggrevated since last 7 days Loss of weight since 10 days  No H/O fever and lose stools History of presenting illness :  Patient is asymptomatic 10 days back then he had loss of appetite and took no food since then and had excess of alcohol . He developed low grade fever 10 days back , sudden in onset , low grade , intermittent , relieved on medication, associated with rigors , no sweating and no evening rise of temperature. Vomiting since 7 days back , multiple episodes in a day like every 1 hour , bilious, Foul smelling, non projectile , not associated with abdominal pain , no headache, no diminision or blurring of vision . Past history:  No history of Diabetes mellitus, Hypertension, TB , Asthma and No history of any cardiovascular disease History of 2 episodes of admission in hospital in vi
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35 year old with shortness of breath

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CHIEF COMPLAINTS A 35 year old who is painter by occupation came with chief complaints of shortness of  breath and fever since 1 week.  HISTORY OF PRESENT ILLNESS  Patient was apparently asymptomatic 1 week back, then he developed  • shortness of breath on exertion, since 1 week. • high-grade fever since 1 week, more during night, relieved on medication and relapses back. • decreased urine output since 1 week • dragging type of pain in both legs and hands, associated with generalised weakness. • orthopnea and PND present since 4 days HISTORY OF PAST ILLNESS No history of DM, HTN, TB, Epilepsy, leprosy, CAD, CVN, Asthma or any other chronic illness. No history of previous transfusion.  PERSONAL HISTORY Built : Weakly nourished Appetite : Decreased since 1 week Diet : mixed Sleep : Decreased since 1 week  Bladder movements:  Anuria since 1 day associated with burning micturition. Bowel movements: regular Addictions : toddy consumer in summer season. Regular alcohol consumer, once a week.
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65 year old male

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Chief complaints :  65 year old male with chief complaints with unable to walk since 3 months , muscle stiffness since 20 days , decreased appetite since 15 days . Unresponsiveness since 3 days.  History of presenting illnesses: Patient is apparently asymptomatic 1 year back then developed unbalanced gait,insidious in onset and visited a hospital ,6 months ago and was said to be having a neurological disease (no documents available) and have been using medication since then(not known)and was having generalised weakness on and off since 6 months and due to fear of falling and as he is feeling pricking sensation over the sole,and due to decreased power in his limbs and generalised weakness he completely stopped walking  and was bed ridden since 2 months(he didn’t tried walking even with support)visited a hospital again 1 month back,MRi brain was done,showing hydrocephalus and early parkinsons changes,and advised for surgery (?Ventriculoperitoneal shunting,not done)and during hospital sta
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