Top differential - Infective carditis secondary to prosthetic valve, with concern about impact on cardiac function due to SOB on exertion and fatigue. Ddx to consider: Lymphoproliferative disorder HIV, TB or abscess, early menopause (primary ovarian failure) but there wouldn't be an actual fever & periods still present.
Great hx taking..It would be relevant to ask any lumps or bumps(lymphoma) , medication allergy (because of the long treatment duration) and any recent procedure e.g tooth extraction
Top differential - Infective carditis secondary to prosthetic valve, with concern about impact on cardiac function due to SOB on exertion and fatigue.
Ddx to consider: Lymphoproliferative disorder HIV, TB or abscess, early menopause (primary ovarian failure) but there wouldn't be an actual fever & periods still present.
Thanks dr punekar
I like his clear and confident conversations
I wish I could work with him
Thankyou sir
Great hx taking..It would be relevant to ask any lumps or bumps(lymphoma) , medication allergy (because of the long treatment duration) and any recent procedure e.g tooth extraction
That’s really helpful. Thank you Dr. Punekar.
D/D
Lympoham
TB
Infective Endocarditis
Spleenic Infection
I think adrenal hemorrhage dt warfarin also fit
Did this new history taking stations now started in overseas centers
Yes I think so
X
Dr Punekar never smiles
Unappreciated comment. This chap is helping others pass exams.
That's not his job