Physiology CBL-2 – CIMS Bwp

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CBL	07
SENARIO:
A 25-year-old male presented to the physician with complaints of inability to perceive any smell. History reveals that one month back he had a road traffic accident and had head injury with multiple facial injuries.
Topics to be studied by students:
Different chemical senses. The pathway of smell and taste Abnormalities of smell and taste.

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CBL	06
SENARIO:	Sleep
A 25-year-old person suddenly wakes up from sleep and start shouting. After some time, he sleeps again and was unable to remember a thing from last night. He also had previous history for such episodes.
Topics to be studied by students:
What are different stages of Sleep? How sleep affects different functions of body. What are brain Waves
SENARIO:	Speech
Zahid a 53 years old businessman was brought to Neurology OPD by his younger brother with complaints of his inability to speak since last morning. He is a known hypertensive for last 20 years but not using his medicine regularly. On physical examination his blood pressure was 190/130 mm of Hg. There was no motor deficit except for inability to speak and he was unable to understand the spoken words as well as the written words. His antihypertensive therapy was read adjusted and blood pressure was brought to 140/90 mm of Hg. What is your likely diagnosis
Topics to be studied by students:
Definition of Aphasias Various types of Aphasias Role of Wernicke’s area and Broca’s area in speech Various types of abnormalities of speech

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CBL	05
SENARIO:
A 30-year-old motor cyclist met a road side accident. He was brought to the hospital in fully conscious state with immobile legs. On examination, right leg was found paralyzed with exaggerated deep reflexes and hypertonia, while left leg was found normal. The tactile discrimination, position and vibration senses of right leg were lost, whereas crude touch, pain & temperature sensation were intact on right side. The examination of left leg revealed loss of pain, temperature & crude touch. Patient bladder was catheterized. The diagnosis of Brown- Sequard syndrome due to injury to the lumbar spine was made. What is your likely diagnosis?
Topics to be studied by students:
Ascending and descending tracts Physiology of deep tendon reflexes Pathology of spinal shock & Brown – Sequard Syndrome

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CBL	04
SENARIO:
The patient came to the emergency department with complaint that he feels severe pain on one side of face since 3 days. The pain has been episodic in nature and trigged when hot takes hot or cold fluids. What is the diagnosis?
Topics to be studied by students:
1. Pain and its types 2. Pain pathway 3. Analgesic System

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CBL	03
SENARIO:
A 21-year-old man with insulin dependent diabetes presents to the emergency center with mental status changes, nausea, vomiting, abdominal pain and rapid respirations. On examination, the patient is noted to be hypotensive, Breathing, rapidly (tachypneic) and febrile. A fruity odor is detected on his breath. A random blood sugar is significantly elevated at 600 mg/dL. The patient also has hyperkalemia, hypomagnesemia, and elevated serum ketones. An arterial blood gas reveals a metabolic acidosis. The patient is diagnosed with diabetic Ketoacidosis (DKA) and is admitted to the intensive care unit for intravenous (IV) hydration, glucose control, and correction of metabolic abnormalities.
Topics to be studied by students:
1. Acid Base regulation 2. Renal and respiratory mechanisms for acid base regulation. 3. Acid base disorders.

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CBL	02
SENARIO:
An 18 years old boy came to OPD of a hospital with complaints of vomiting and diarrhea since last night. He gave history of taking lunch at a local restaurant a day before yesterday about a day after that lunch, he developed nausea followed by profuse vomiting and watery diarrhea. On general physical examination, moderate dehydration was noticed. Laboratory investigations revealed presence of E. Coli in stool, TLC12,000/µl with neutrophils 75% and serum levels of Na+ (138 meq/l). Patient was given anti emetic drug along with rehydration salt (ORS) and appropriate antibiotics. He was advised to observe hygienic eating hygienic eating habits to avoid such incidence in future.
Topics to be studied by students:
1. Enteric and autonomic nervous system in GI functions. 2. Functions of stomach and factors affecting gastric emptying. 3. Functions of small & large intestines. 4. Defecating and vomiting reflexes. 5. Pathophysiology of diarrhea.

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CBL		01
SENARIO:
A-5-Year old boy presents to the urgent care clinic because his mother noticed that the child is not going to the bathroom and his feet are swollen. Two Weeks earlier the child was treated for streptococcal throat infection with penicillin. The mother admits to stopping administration of medication to the child after a couple of days because she thought the child felt better. Physical Examination : Vital Signs: Temp 37 C, Pulse 78/min, Resp rate 15/min, BP 120/90 mm hg Physical Examination : The patient has oliguria and has a slight fluid accumulation in the lower extremities and periorbital region. There is palpable peripheral edema in both feet. Laboratory studies: Urinalysis : very dark urine, presence of red blood cells, red blood cell casts and protein (>3 g/day)

Topics to be studied by students:
1.Morphology of a typical nephron and its blood supply. 2. Glomerular Filtration rate, how it can be measured,list the factor effecting it. 3. Autoregulation and list the major theories advanced to explain autoregulation in the kidneys.