Medicine virtual case bank

26 year old male, construction worker by occupation presented to the casualty with the chief complaints of  Fever since 3 months  Cough with expectoration since 2 months  Dyspnea on exertion since 2 months  Vomiting since 2 months  Decreased appetite and weight loss over last 2 months  Dark coloured stools since 2 weeks  History of presenting illness:- Patient was apparently asymptomatic 3months back till when he attended his relative function where he consumed alcohol for 2days ( Around 8 beers) following which after 2days he developed high grade fever though not associated with chills & rigors or Night sweats and it subsided with medication for 1 week but from then he's having on & off fever.  The following month he started experiencing productive cough with mucoid expectoration, blood tinged amounting to 2 to 3 cup's per day it's foul smelling .  He also started feeling difficulty in breathing on walking for small distances . It's...

60yr known hypertensive female since 5yrs on irregular medication  who's apparently asymptomatic 2days back till afternoon when she had her lunch and washed clothes & at around 2.30pm she suddenly developed Giddiness and swaying towards right side associated with drooping of rt eye lid. She had an episode of vomiting and was taken to outside hospital with support where her BP is 200/100mmhg for which an antihypertensive was given & referred to our hospital. O/E Pt c/c/c Pupils- RE smaller & sluggish reactive. Speech- ?hoarseness HMF- Intact CN- RE- sluggish reactive pupil,        Placed Mango 🥭 juice on tongue & she said √sed sensation Gag- +nt Motor system- Reflexs +nt, power 5/5 , Reflexs- 2+ , plantar - b/L mute Sensory- face Rt half &  Left half of body                decreased pain & temp sensation Cerebellum - Gait- couldn't be examined as she's having giddiness. IMP- Lateral medullary s...