BDS 2nd internal assessment

Essay

1. Anatomical and etiological localization for hemiparases and further management 











2. Etiology pathogenesis clinical features management complications of acute pancreatitis?


3. Dengue fever, clinical features, complications 









4.cushing syndrome




5. Mandibular advancement device?

6. Cardiogenic pulmonary edema



Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder and is characterized by recurrent episodes of complete or partial obstruction of the upper airway leading to reduced or absent breathing during sleep.

Common symptoms of OSA syndrome include unexplained daytime sleepiness, restless sleep, and loud snoring (with periods of silence followed by gasps)

The fundamental cause of OSA is a blocked upper airway, usually behind the tongue and epiglottis, whereby the otherwise patent airway, in an erect and awake patient, collapses when the patient is lying on his or her back and loses muscle tone upon entering deep sleep.

At the beginning of sleep, a patient is in light sleep and there is no tone loss of throat muscles (muscle tone of throat and neck is usually attenuated during sleep --> tongue and soft palate relax --> airway patency reduced --> complete obstruction to the airflow). 

Airflow is laminar and soundless. As the upper airway collapse progresses, the obstruction becomes increasingly apparent by the initiation of noisy breathing as air turbulence increases, followed by gradually louder snoring as a Venturi effect (reduction of fluid pressure that decreases when a fluid passes through a constricted vessel) forms through the ever-narrowing air passage apnea

https://en.m.wikipedia.org/wiki/Obstructive_sleep_apnea


The mandibular advancement device treats snoring and sleep apnea by moving the lower jaw forward slightly, which tightens the soft tissue and muscles of the upper airway to prevent obstruction of the airway during sleep. The tightening created by the device also prevents the tissues of the upper airway from vibrating as air passes over them—the most common cause of snoring

https://en.m.wikipedia.org/wiki/Mandibular_advancement_splint

The patient had generalised attrition (flattening of occlusal surface of almost all teeth).

The patient details are discussed in the blog below 

http://alekhya09.blogspot.com/2021/11/osa.html

Reason for attrition and TMJ disorder in OSA patients : 

"when tongue collapses posteriorly causing reduction in airway space body may activate its inbuilt protective mechanism wherein it moves the mandible forward unconsciously to make space for air in upper airway region leading to attrition of teeth and this action caused by forward movement of mandible repeatedly leads to excessive strain over TMJ causing TMD in the long run"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056072/




7. Rheumatoid arthritis

8. Leptospirosis





9. Heart failure



10. Ascites




Very short notes

11. Pyrexia of unknown origin

12. Drug induced liver injury




13. Evaluation of low back achr

14. Renal artery stenosis




15. Acute kidney injury

16. Oral hypoglycemic agent




17. Micro and macrovascular of diabetes 

18. Lights criteria




19. Metabolic acidosis

20. Iron deficiency anemia





Comments

Post a Comment

Popular posts from this blog

HONC leading to altered sensorium

Image
  This is an online e-log book to discuss our patient's de-identified health data shared after taking his/her/guardian's informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. Date of admission :   04 February 2022 A  50 year old male who works in a hotel came to the OPD with the chief complaint of loss of consciousness  History of present illness :  The patient was apparently asymptomatic one day before. He had a night meal with 90 ml of whisky which was his daily routine. He later experienced discomfort, started behaving abnormally as in talking irrelevant things and lost consciousness. History of past illness : Patient is diabetic since 15 years (experienced giddiness and got checked) The patient was injured by a motor vehicle silencer  4 months back and the...
Read more

General medicine case 1

Image
  This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. Here, we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs. A 48 year old male patient presented to the OPD with the chief complaint of fever and swelling in the right lower limb since 4 days. History of present illness : - Patient was apparently asymptomatic 4 days back then he noticed a swelling on the right lower leg due to trauma.  - The swelling is associated with pain, no discharge, no sinuses.  - It is associated with low grade fever and is intermittent.  - Fever is not associated with chills and rigors. History of past illness :  - There is no history of diabetes, hypertension, asthma, tuberculosis, epilepsy - There is no history of surgery...
Read more

General medicine case 6

Image
  This is an online e-log book to discuss our patient's de-identified health data shared after taking his/her/guardian's informed consent. Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.  Date of admission : 27 October 2021 A  48 year old male who is farmer by occupation came to the OPD with the chief complaint of pedal edem a   History of present illness :  Normal routine of the patient :  The patient wakes up by 3 AM daily, carries out all the cattle work along with household work, will have his breakfast by 8 AM (rice and curry), goes to the field and does farming, then he used to have his lunch by 1/2 PM (rice & curry or roti) and return home by 6.30/7 in the evening. Then he used to have his dinner (rice again) and sleep by 8 PM. The patient was apparently asymptomati...
Read more