Clinical Cases

October 15, 2010

How Cigarette smoking influences the risk of heart attack

Filed under: survey — Birds-eye @ 6:15 pm


A mini study was carried in CMC hospital, among 20 heart attack (Myocardial Infarction) patients, on 7-10-10 and

14-10-10 respectively, to identify how Cigarette smoking influences the risk of heart attack.

The Survey was conducted by : G.A.D.M.Ganepola
Assisted by:

It was found that among 20 patients with a recent history of  a heart attak, 19 had a history of cigarette smoking.

Among the smokers who had a history of a heart attack, 2/3rd were consuming atleat 5 packs per year,.



September 29, 2010

The patient with high fever and bodyache

Filed under: Case Study — Birds-eye @ 2:03 am

21 Years old male, developed sudden pain in the both lower limbs, which was dull in nature and increased with walking,  it did not radiate or shift. The pain was moderate and on  1 – 10 scale, it was 7.

After Several hours, patient gradually developed fever, on the first day it was around 100F and rose  to 104F on the second day, giving rise to chills. It was fluctuating in nature.  Fever pattern is shown in the graph. Fever subsided after 4 days of its onset.


On the 2nd  day patient vomited several times, often after taking meals. Vomitus containd food materials and did not contain blood. Vomiting was not projectile.  The patient continued vomiting during next 4 days. The patient lost appetite by the 2nd day yet regained after 4-5 days. On the same day patient gradually developed, moderate pain in the left lumber quadrant of the abdomen and next day the pain was presented both lumber quadrants of the abdomen. It was dull in nature and was confined to the area. The Pain persisted throughout the day and relived after 4 days.

During first few days patient noticed appearance of small red spots in the skin especially in the upper and lower limbs. There were about 10 spots. they disappeared after 4-5days.


November 10, 2009

Case study 5

Filed under: Case Study — lahirusilva @ 12:02 am

A 40 year old man complains of yellow discolouration of sclera tea coloured urine and clay coloured stool for 3 months duration had suddenly developed a colicky type of abdominal pain intermittent in nature and radiates to the two hypochondriums releived by induced vomitting since one week. He gives a past surgical history of cholecystectomy in 2006 .He gives no history of loss of apetite or weight loss or fever with chills and rigor he has been non alcoholic since 25 years and only taken drinks for three years no P/H/O of hepatitis i.v drug abuse or blood transfusion

a.what could be the rasons for his jaundice and which is most likely

b.what could be the reason for the sudden onset abdominal pain

c. what will be the single simple investigaion you would like to perform on this patient and why

November 6, 2009

EPRM (ACT 16) Syllabus and Guidelines

Filed under: Act16 — Birds-eye @ 3:36 am
Tags: ,

ERPM – The Examination for Registration to practice medicine in Sri Lanka

Please use the following link to download ERPM syllabus.
Please use the following link to download ERPM Guidelines

Case Study 4

Filed under: Case Study — Birds-eye @ 3:07 am
Tags: , ,

A 25-year-old male presents complaining of several weeks of itching lesions on his legs and arms. On exam, there are sharply demarcated erythematous plaques with silvery scale on the lower legs and extensor surfaces of the arms bilaterally. Which of the following drugs would be most likely to alleviate the patient’s symptoms?

A. Amoxicillin, oral
B. Betamethasone, topical
C. Fluconazole, oral
D. Ketoconazole, topical
E. Mupirocin, topical

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