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OSCE AND LEARNING POINTS

OSCE QUESTION AND ANSWERS: 1) What is the mechanism of action of insulin at cellular level? Insulin acts on a glycoprotein- tyrosine kinase receptors on the cell membrane and it binds to the alpha subunit which leads to phosphorylation of beta subunit. This leads to transport of GLUT RECEPTORS on to the cell membrane which in-turn transports glucose into the target cell( adipocyte and muscle cell); Gluconeogenesis is inhibited and glycogenesis is stimulated in the liver cell with the action of insulin on it; All these leads to decrease in the blood sugar hence it usage in hyperglycaemic state; 2)How do you differentiate a patient clinically on the bedside whether the patient is type1 or type 2 diabetic? In type 1 diabetics the beta cells are 100% destroyed and hence supplemenation with secretagogues(hypoglycaemic drugs) would not benefit the patient clinically whereas in type 2 diabetics almost 10-30% of beta cells are functional hence we can boost them up with secretagogues and increa
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A 40 YEAR MALE WITH COMPLAINTS OF BOUTS OF VOMITINGS

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 01/12/23; This is an 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. Ihave been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan. A 40 years male, resident of chityala, field assistant by occupation came to the opd with chief complaints of vomitings Since 6:00pm yesterday; History of presenting illness: Patient was apparently as
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2 internal answer sheet (14/07/23)

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Sudden onset involuntary movement of lower limb

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 3/7/23; This is an 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. Ihave been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan. A 52 year male, resident of lingotam,farmer by occupation came to the casualty with chief complaints of; Involuntary movements of the right lower limb since morning(6:00am); Numbness of right lower limb
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Facial puffiness with associated pedal edema

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  June 11, 2023 This is an online E logbook 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 an available global online community of experts 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 on the comment box are welcome. a 53-year-old male, a Hotel owner and chef by occupation, The patient presented to the hospital with chief complaints of Swelling of both Legs since 10 days Swelling of face since 7 days HISTORY OF PRESENTING ILLNESS   The patient was apparently asymptomatic 10 days ago.In the first week of June he had a binge of alcohol on occasion of local festival. Later he observed abdominal distension, followed by Bilateral Pedal odema which is pitting type extending up to the knee, insidious
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