Confused aatma

[Dr Sudhir Kumar MD DM @hyderabaddoctor]

Betahistine tablet is not the solution for dizziness (vertigo) due to every cause; instead stopping a medicine can resolve giddiness in a few cases

➡️Dizziness (also known as giddiness or vertigo) is a common symptom, with which patients present in our OPDs (Medicine, ENT or Neurology depts).

➡️Dizziness can be caused by a variety of causes. Careful history taking and examination can help us sort out the underlying cause in several cases.

➡️Case details
55-year-old person presented with dizziness for the past 6 weeks. Symptoms occurred only when he stood up from lying down position. Dizziness subsided on its own within a few minutes on assuming upright posture.
He had been prescribed betahistine (Vertin) tablets by his local physician, which did not help him.
History was very typical of a condition: POSTURAL HYPOTENSION.
Simple clinical examination confirmed this suspicion. BP in supine position was 120/80 mmHg. On assuming upright posture, BP dropped to 90/65 mmHg.
He was taking two different medications for hypertension (high BP). I stopped one of them.
He did not have recurrence of symptoms of dizziness after that.
➡️In this case, the patient needed STOPPING of one medication for treatment. Instead, a new medicine had earlier been (erroneously) ADDED by the local doctor.
Take home message
1. In a patient who complains of dizziness upon standing from lying down position, suspect a diagnosis of postural hypotension.
2. Addressing the underlying cause of postural hypotension would resolve the issue.

[Confused aatma @Kneehall_]

@bhat1405 Nope

[Confused aatma @Kneehall_]

Patient came with the only complaint of multiple non tender, non mobile non fluctuant swellings all over the body. No h/o fever.
Pallor present. Rest examination normal
On routines mild anemia with reversal of A/G ratio. Rest was normal. Electrophoresis showed M band presence ..

[Confused aatma @Kneehall_]

@bhat1405 High total protein with reversal of A/G ratio. Forgot to mention it

[Confused aatma @Kneehall_]

FNAC showed plasmacytoma
BM biopsy showed >60% plasma cells.
Never thought multiple myeloma would present like this. Will bever forget this case

[Confused aatma @Kneehall_]

Peripheral smear is my favorite investigation.

[Confused aatma @Kneehall_]

Best source to learn how to manage sugars for a patient with uncontrolled sugars but not in DKA?
#MedX

[Confused aatma @Kneehall_]

Day 2 of medicine residency. Realising that the most important skill I have to develop is to form the working diagnosis

[Confused aatma @Kneehall_]

Lowkey excited to start residency. But I know 1 week in and I'm gonna be depressed and missing home

[Confused aatma @Kneehall_]

@ArtemKRSV This was a beautiful video Artem. Easy to understand for someone with even a little understanding of neuronal functions. The visuals helped a lot

[Confused aatma @Kneehall_]

In the long run it doesn't show up "clearly and obviously"

[Dr Shaurya Garg @DrShauryaGarg]

It might sound arrogant and narcissistic, contrary to popular opinion, but where you do your MBBS from, really shows. very clearly and obviously, it shows👀

[Confused aatma @Kneehall_]

@panshul_pant Thanks bro

[Confused aatma @Kneehall_]

Life Update : Left anesthesia residency at AIIMS, Delhi at the start of this year due to personal reasons. Took up MD General Medicine this year through NEET PG at Kalinga Institute of Medical Sciences. Incredibly lucky and privileged to be in this position to change my field 🙏

[Confused aatma @Kneehall_]

@the_shreminator Thanks bro

[Confused aatma @Kneehall_]

@anshu_agrawal97 💙💙

[Confused aatma @Kneehall_]

@nagaraaj_kamath Thanks man

[Confused aatma @Kneehall_]

Been single since 6 months and now I'm finding out couples that I never thought would break up have also broken up is the weirdest kind of schadenfreude.

[Confused aatma @Kneehall_]

@yatharth797 Mood

[MrBeast @MrBeast]

I’m gonna give 10 random people that repost this and follow me $25,000 for fun (the $250,000 my X video made)

I’ll pick the winners in 72 hours