30 year old male with chronic pancreatitis and gastritis

   This online E-log Entry Blog is an objectively structured clinical examination method to assess the clinical competence during the course of my General Medicine Internship rotation (october'2023-november'2023) by reviewing the case reports shared below and to discuss, understand and review the clinical scenarios and data analysis of patients so as to develop my clinical competency in comprehending clinical cases, and providing evidence-based inputs for questions surrounding the clinical vignettes borrowed from the E Log Book. Note: The cases have been shared after taking consent from the patient/guardian. All names and other identifiers have been removed to secure and respect the privacy of the patient and the family This is a case where I presented in the CME meet : A 47 year old male patient came to casualty with chief complaint of spasms of both upper and lower limbs since one day HOPI: Patient was apparently asymptomatic one day back then he developed spasms in his both

  C/o shortness of breath since 1 week C/o generalised weakness since 1 week  Pt was apparently asymptomatic 1 week back then she developed shortness of breath , grade 2, aggregated on exertion , gradually progressed to grade 4 . H/ o orthopnea present , no PND.No seasonal variation,no diurnal variation.No h/o fever,cold,cough.no weight loss.no pedal edema. Past history: K/c/o HTN  K/c/o HFrEF Not a k/c/o Dm2,CVA,CAD,epilepsy Personal history: Diet: vegetarian  Apetite: decreased Bowel and bladder: regular Sleep: disturbed  GENERAL EXAMINATION: Patient is conscious,coherent and cooperative, moderately built and malnourished Pallor: absent Icterus: absent Cyanosis: absent Clubbing: absent Lymphadenopathy: absent Pedal edema: present VITALS: Temperature: 98 .2F Pulse: 124beats/minute Blood pressure:120/80mm Hg Respiratory rate:20cpm Systemic examination  CVS - S1 S2 heard R/S -  No wheeze  Diffuse crepts present no palpable mass, Trachea- central Vesicular breath sounds heard P/A -  Scap