THIS IS AN ONLINE E LOG BOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS 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.
[09-07-2025 16.55] PPM 1: Afternoon session second patient: 54M with progressive atypical tremors, anorexic, dysphagia, dyarthria, inability to walk over few months. On examination hypertonia of all limbs with trunkal hypotonia, neck stiffness and oro facial dyskinesia with atypical tremors as in video link.
[09-07-2025 16.57] PPM 1: Atypical progressive extrapyramidal features with cachexia over months: https://youtu.be/ePpQ6W0QaL8?feature=shared
[10-07-2025 15.38] PPM 1: 👆Afternoon session:
I was hoping @PPM3's LLM would comment on the chest X-ray shared yesterday.
However it's looking quite different today attached here
[10-07-2025 16:18] Rakesh Biswas Sir: 👆@~Dr.Abdulsalam the 54M's previous chest X-ray was here and it was earlier wrongly interpreted by me and I got surprised on seeing his repeat chest X-ray today which your LLM already commented on but I want it to comment on this one
[10-07-2025 16:21] PPM 3: This chest X-ray shows bilateral pulmonary infiltrates that appear more prominent on the right side. Key observations include:
Findings:
Diffuse bilateral infiltrates, suggesting possible pneumonia, pulmonary edema, or ARDS.
Right-sided prominence, possibly indicating asymmetrical consolidation or infection.
Presence of two round radiopaque foreign bodies over the mid zones of both lungs — these are likely ECG leads or external markers, not internal.
Diaphragmatic outlines are partially obscured, especially on the right — consistent with lower zone involvement.
No obvious cardiomegaly seen, though the lower heart borders are poorly visualized due to overlapping opacities.
Differential Diagnoses:
Infective process (e.g., bilateral pneumonia — viral, bacterial, or aspiration)
Pulmonary edema (cardiogenic or non-cardiogenic/ARDS)
Diffuse alveolar hemorrhage (if hemoptysis present)
Less likely: Pulmonary contusion (if trauma history) or vasculitis
Next Steps:
Correlate clinically: fever, dyspnea, oxygen saturation, auscultation findings.
ABG, inflammatory markers (CRP, procalcitonin), blood cultures.
Consider CT chest if diagnosis remains unclear or if rapid progression is noted.
Would you like a comparison with previous X-rays or correlation with recent labs/symptoms?
[10-07-2025 16:25] PPM 1: Thanks. No it didn't get it which is a relief
No comments:
Post a Comment