39F with Post Operative Abdominal Problem Telangana PaJR

 

06-02-2025

PPM 1 - OPD right now. 39F with a post operative abdominal problem earlier answered here by @PPM3 She also has a arm adiposity which appears autosomal dominant from a quick sketchy family tree probe and we did share another similar arm lipodystrophy here earlier although I guess we couldn't archive.

Yes will need to see how we may be able to harness multi agent AI to resolve this challenge.

Let me introduce @PPM4 who is a data scientist and has joined us yesterday to see what are the pressing AI healthcare requirements we and others have that can be tackled and scaled impactfully.

PPM 4 - Thanks for the introduction, @PPM. Kindly let me know if anything related to AI is required.

PC- 

Post-operative abdominal issue

Arm adiposity with suspected familial inheritance

Blood Tests

1) Fasting blood glucose, HbA1c

2) profile (HDL, LDL, triglycerides)

3)Liver enzymes (AST, ALT)

4) Serum insulin levels

5)BP monitoring

••Referral for LMNA gene mutation testing commonly implicated in FPLD Type 2.(inheritance pattern)

Suggest lab - CCMB - Hyderabad

•• regular Follow-Up Every 3 months.

PPM 1 - Appreciate the first para of what you wrote (the other inputs are good data for our medical education project where we are dealing with this current pandemic of over-testing and overtreatment trying to utilise medical cognition solutions looking to benefit from AI agents)

I vaguely recall you may not have diagnosed the previous similar post operative abdominal issue and will now share that answer without further ado. It's incisional hernia.

I also appreciate the third para where you have talked about the genetic association of the phenotype we described. Although the genetic tests may be an overkill in terms of overall meeting the patient requirement it would be nice if you could share more about familial lipodystrophy especially the phenotype and let's also ask @Meta AI 

Meta AI

Familial lipodystrophy is a rare genetic disorder characterized by the abnormal distribution of body fat, often resulting in a lack of fat in certain areas of the body. There are several subtypes, including:

1. Familial partial lipodystrophy (FPLD): characterized by loss of fat from the arms, legs, and buttocks.

2. Familial generalized lipodystrophy (FGLD): characterized by a near-total loss of body fat.

3. Mandibular lipodystrophy: characterized by loss of fat from the face and neck.

These conditions are often associated with metabolic complications, such as insulin resistance, diabetes, and cardiovascular disease.

Genetic mutations in various genes, such as LMNA, PPARG, and AKT2, have been linked to familial lipodystrophy. These genes play critical roles in adipocyte development, differentiation, and function.

If you'd like to know more or discuss further, please let me know!

PPM 1 - @Meta AI what about lipodystrophy patient phenotypes where there is excessively abnormal fat distribution or is it always loss of fat?

Meta AI 

While the term "lipodystrophy" often implies fat loss, some forms of lipodystrophy can indeed present with excessive or abnormal fat distribution.

For example:

1. Generalized lipodystrophy with excess fat: Some patients may experience an abnormal distribution of fat, with excess fat accumulation in certain areas, such as the face, neck, or abdominal region.

2. Lipohypertrophy: This is a condition characterized by the accumulation of excess fat in specific areas, such as the abdominal region, buffalo hump (fat accumulation on the upper back), or lipomas (benign fat tumors).

3. Mixed lipodystrophy: Some patients may exhibit a combination of fat loss and excess fat accumulation in different areas of the body.

These phenotypes can be associated with various genetic mutations, metabolic disorders, or other underlying conditions.

It's essential to note that lipodystrophy can manifest differently in various individuals, and a thorough medical evaluation is necessary to accurately diagnose and manage these conditions.

PPM 1 - Our patient's condition should have been termed lipo-hypertrophy.

PPM 3 - Yes, sir.

PPM 1 - Thanks @PPM4

We are hoping you will be able to formulate some plans once you keep seeing how we use AI in our day to day healthcare workflow along with how we share AI keywords such as "multi agent" shared above to describe the users in one of our PaJR groups that are currently human human agents but are also amenable to becoming AI agents.

Overtime you will get to figure out the pattern and the best possible scalable requirement that you may want to work on.

PPM 3 - Sir , doplar USG HA. any report..!

PPM 1 - HA?

PPM 3 - Whole abdomen USG this present.

PPM 1 - HA means whole abdomen?

Why do you need a USG abdomen?

https://nautil.us/why-doctors-test-too-much-1188119/