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Showing posts from December, 2023

osce learning points

Dec 7 2023 OSCE questions 1. What are bronchial breathsounds how to differentiate it from vesicular breath sounds  I have learnt how to identify bronchial breath sounds clinically  Brochial breath sounds It is loud, hollow, and high pitch Expiratory phase is longer than inspiratory phase There is distinct pause between inspiration and expiration due to absent alveolar phase Vesicular breathsounds Soft, low pitched, and rustling in quality   a) Inspiratory phase remains  longer than the            expiratory phase    b)   Inspiration is higher pitch than expiration    c) No pause between inspiration and expiration What are crepitations? How they occur ? Crepitations are adventitious breath sounds.  Crepitations are made either by air passages and alveoli (air sacs) opening up during inspiration or by air bubbling through fluid. They are not normally heard in healthy lungs. During expiration alveoli stick together while during inspiration the alveolar walls are seperated with difficulty

Prefinal -83 year old male with shortness of breath with pnemonia

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This is an a online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. The patient/ attender was informed the purpose of the information being acquired. An informed consent was taken from patient/ attender and there is omission of information that was requested to be omitted. A 83yr old male came with complaints of   cough since 20 days Fever since 19 days Shortness of breath 17 days  History of Presenting illness: Patient was admitted to ICU on 20/11/23 in the morning at 10 am with  breathlessness. It was insidious in onset and gradually progressive, continuous a