OSCE towards optimizing clinical complexity

 Introduction: This online E-log Entry Blog is an objectively structured clinical examination method to assess the clinical competence during the course of my General Medicine Internship rotation (June'2023-August'2023) by reviewing the case reports shared below and to discuss, understand and review the clinical scenarios and data analysis of patients so as to develop my clinical competency in comprehending clinical cases, and providing evidence-based inputs for questions surrounding the clinical vignettes borrowed from the E Log Book.

Note: The cases have been shared after taking consent from the patient/guardian. All names and other identifiers have been removed to secure and respect the privacy of the patient and the family.


Case history:

A 30 year old male came to casualty with c/o involuntary movements of hands and tingling and numbness in upper limbs and abdomen since yesterday morning 

Patient was apparently asymptomatic 20 days back then he developed fever insidious in onset, gradually progressive, low grade , intermittent not associated with chills and rigors and relieved by medication

He has a history of 4-5 episodes of vomitings 5 days back. Watery, non bilious ,non projectile, with food particles as contents.

Relieved by medication (unknown)

No c/o pain abdomen, loose stools  

c/o burning micturition 2 days back, relieved now

H/o similar complaints in the past(7 years back) (hypokalemiac periodic paresis)

No h/o DM,HTN, asthma, epilepsy,cad, thyroid disorders 

He used to take alcohol occasionally for the past 10 years and stopped taking 1 month back

He takes betel leaf(pan) once in 2 days for the past 10 years 


1)List all the complaints of the patient related to hypokalemia


2)Why did the patient develop all the symptoms listed above 20 days back 

Can we relate the potassium levels to the patient symptoms? 

3)

What level of  hypokalemia cause tingling and numbness ?

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