17-02-2025
This is an Online E Log Book to discuss our patient's de-identified health data shared after taking her signed informed consent. Here we discuss our patient's problems through series of inputs from available global online community experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.
OPD patient 20F with a history of bothersome neck flutter!
This appears to be a physiology bench to bedside story @PPM3 @PPM4!
Initially thought to be neurological fasciculations but later on clinical examination turns out to be a hyperdynamic physiological response to hemodilution! Had shared her and two other nails above earlier!
Here's her neck flutter initially thought to be localised segmental fasciculations on history but hyperdynamic pulsations on examination 👇
https://youtube.com/shorts/mGRwVVe68EE?feature=shared
19-02-2025
PPM 1 -
Congratulations intern for this remarkable patient centered learning contribution in a young patient with neck flutter where because of your good clinical skills (inspite of my bad ones going contrary) you persisted in your diagnosis of anemia to explain her neck flutter due to hyperdynamic circulation and also did a small study with more controls to study the reason for neck flutter when most of her investigational hemodynamic parameters came normal! 👏👏
Incidentally we had another similar age patient visiting us in the OPD at the same time right now with a similar hemoglobin but notice the differences in the nails (the middle one being that of our other intern serving as a nail control). This other patient's anemia is due to her Crohn's disease and that makes her nails clubbed where we can expect a high ferritin level while Latisha's patient's anemia is likely due to iron deficiency and you can check out her flat nails!
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