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osce and learning points

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Osce questions- Risk factors for BPH -men over 50 years of age -men who are obese -men whose fathers have BPH -some men with erectile dysfunction Features of BPH -incomplete emptying of bladder -increased frequency of urination -urgency of urination -nocturia -weak stream of urine Diagnosis: Symptom score index: first step to diagnose BPH   Digital rectal examination:   Patient lies on his side or bend over.The doctor inserts the gloved finger in to rectum to feel the back of the prostate gland. The doctor is looking for enlargement, tenderness, lumps or hard spots. Urine analysis:         •  Urine tests for blood, protein, signs of infection, sugar .         •post void residual volume         •uroflometry          Scans:         •ultrasound         •cytoscopy         •MRI and CT Blood tests:         Prostate specific antigen Confirmatory test:         Transrectal ultrasound        Multiparametric MRI   Learning points       A
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A 63 year old male patient resident of marripeda bangla

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OA 63 year old male patient residence of Marripeda bangla came with Cheif Complaints :- Complaints of increased frequency of passage of urine since one month. Complaints of fever since 1 month Back pain since 15 days Vomiting Since one day History of presenting illness Patient was apparently aAsymptomaticsymptomatic one month back then he developed burning micturition which was insidious in onset, no aggravating and relieving factors   Complaints of increased frequency of urine approximately 20 times a day and increased passage of urine during night Times approximately 5 times since 1 month. fever was insidious in onset, gradually progressive ,intermittent , associated with chills and rigors, low grade, relieved on medication Back pain sudden in onset dull aching which started after fall from the accident. Complaints of vomiting since one day, non projectile, non bilious 4 episodes, food as content Complaints of shortness of breath since 5 days Patient feels Dehydrated since 5 days No
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swelling on right leg

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C/o swelling of right lower limb since 5 days. HOPI Patient was appalently asymptomatic 5-6 days back, then he developed a small swelling over right lower limb near ankle  joint which he scratched and later swelling gradually increased.Associated with pain.On checking GRBS at presentation blood sugar levels found to be 542 mg/dl. No H/o fever,Nausea ,vomiting,Burning micturation. Past history: Known case of DM type 2 since 9 years on GLIMI M2 N/K/C/O HTN,CVA,CAD,TB,Epilept,Thyroid disorder. Personal history: Patient is tailor by occupation since his age 18.He wakes up at 6 :00 AM ,he freshesup for work,starts his work by 8 AM.He has his Breakfast by 9 AM,and starts work again .He has his Lunch at 1 PM and continue his Work untill 6 PM Dinner at 8 PM .He goes to sleep at 10 PM. Diet - mixed  Appetite - Normal  Sleep-adequate  Bowel -Hard stools  Bladder - No burning micturation. Family History:No significant  Fever chart : General examination: Patient is conscious coherent and co operat
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60 old year female with high grade fever,genelarized weakness since 3 days

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I am presemting a case of 60 year old female, house wife resident of addaguduru, came to opd with Chief complaints: High grade fever since  6 days, not associated with chills and rigor, complaints of weekness since 2 days.  History of present illness: Patient was apparently asymptomatic 5 days back and then she developed fever  high grade , continuous not associated with chills and rigor  C/o generalized weakness since one day, urinary incontinence,  So they went to local hospital and got to know that she is having thypoid and increased sugar levels in the body , so they have brought her to kamineni No c/o nausea , vomitings , no abdominal pain,  No loose stools no cough cold Past history:  known case of dm type 2 since 10 years  Previously using glimeperide 2 mg,metformin 500 mg Since thursday glimiperide 1 mg , metformin 500 mg Not a known case of HTN, CVA,CAD, epilepsy, bleeding diaorder.  Patient has h/o diabetic retinopathy since 5 years.  PERSONAL HISTORY:   Diet - Mixed  Appetit
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A patient with swelling on left leg

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A patient aged 77 year old came to opd with  Cheif complaints:  swelling on left leg since 15 days, low grade fever since 15 days History of present illness  :  patient was apparently asymptomatic 15 days ago, then he developed swelling in his left leg           -which is insidious in onset,           - gradually progressive           -no relieving or aggravating factors Low grade fever since 15 days          - not associated with chills and rigors          -no cough and cold          - relieved on medication No shortness of breath No palpitations, chest pain History of trauma is present Past history :           Known case of hypertension since 8 years Not a known case of diabetes mellitus , epilepsy, thyroid Had cellulitis,necrotizing infection 6 years ago on left leg Had a accident with car 9 years ago,had a tibia implant 9 years ago, it was removed 5 years ago Personal history :            -mixed diet            -regular bowel and bladder movements            - adequate sleep      
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internal assessment on 14/7/23

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question paper
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