Medicine virtual case bank

Chief complaints:- Complaint of fever since 2 days. Complaint of body pain since 2 days. Complaint of vomiting since yesterday (4 episodes). Complaint of abdominal pain since yesterday. --- History of Present Illness:- Fever: Insidious in onset, gradually progressive, intermittent type, relieved by medication. Body Pain: Generalized myalgia since 2 days,affecting both lower limbs. Vomiting: Since yesterday, non-projectile, non-bilious, non-blood tinged, contains food particles. Abdominal Pain: Since 2 days, tenderness present in the epigastric region. --- Past Medical History Admitted 15 days ago for viral fever. --- Birth History Born via Normal Vaginal Delivery (NVD), birth weight: 3.2 kg. No NICU admission. Development History Development appropriate for age. Family History No contributory medical history (NCM). Immunization History Immunized up to date. Physical Examination Vitals: Pulse Rate (PR): 120 BPM Blood Pressure (BP): 104/60 mmHg Temperature: 98°F Respiratory Rate (RR): 24...

DIAGNOSIS- 1)  AREA POSTREMA SYNDROME SECONDARY TO DEMYELINATION 2) SERONEGATIVE PRIMARY CNS DEMYELINATION DISORDER HOPI- C/o gait instability with swaying on b/l sides during walking, not worsening with closing eyes or on walking on smooth surfaces noted since 1 year progressive with time and duration . 2 month later patient developed intractable vomiting that is immediate post prandial vomiting a/w nasal regurgitation of solids and liquids since 1.5 month. Weakness of the left hemiface with inability to close left eyelid. No risk factors  O/E Conscious, oriented obeying commands EOM- gaze evoked nystagmus B/l primary posture normal MMSE-30 Motor- Power -5/5 Tone - normal DTR- 3+ Plantar-b/l flexor Sensory: proprioception -normal Vibration -normal Pain, temperature, touch- normal Meningeal signs- negative Cerebellar signs: B/l UL- dysmetria        LL- incordination + Cranial nerve- Left LMN- Facial palsy Gag reflex -hyporeflexia Rest cranial nerves - norma...

Chief complaints :- C/o Fever since 10days C/o Weakness of Left U/L & L/L since 4 days. HOPI: - Patient is a/a 10 days back then she had fever which is on & off with moderate to high grade in Severity Which is reliving with medications. Since 4 day's patient noticed weakness of left LL which is sudden in onset & gradually progressive in nature & is associated with difficulty in walking in the form of difficulty in wearing chappals how ever she's able to walk , Stand  from sitting position without support & Next day she noticed weakness in left U/L Predominantly she's unable to hold glass of water, Pen, Mix food how ever she's able to lift the limb over the head. H/o headache Predominantly in frontal region during fever episodes. No h/o vision / sensory symptoms No h/o vomitings, ear discharge  No h/o seizures, LOC, altered behaviour  No h/o B× B symptoms No h/o bleeding Manifestations. Past history:- No h/o similar complaints in past.  8 yrs back ...