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second internal theory paper

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second internal practical exam : case of 65 year old male with Sob and stomach pain

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5/12/22: CHIEF COMPLAINTS :-  Pain in the lower abdomen for 5 days  Shortness of breath for 5 days HISTORY OF PRESENTING ILLNESS :-  The patient was apparently asymptomatic 25 years back then he had a cough that was blood-stained when he was diagnosed with Tuberculosis and was on ATT for 6 months after he was said that he is free from the disease. Then 2 years back then he started having shortness of breath Grade 2 ( sob on some physical activity) which is insidious in onset and relieved temporarily on medication, from then he had intermittent shortness of breath which relieved on the medication temporarily.  6 months back he again developed shortness of breath of grade 2 ( walking after 300 m ) which is insidious in onset where he was taken to a higher center where he was prescribed a medication that he didn’t use properly and used only on the aggravation of shortness of breath. After that 5 months back he suffered from an accident where his left tibia and left rib got fra