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  GENERAL MEDICINE CASE PRESENTATION A.S.SIVARAM Roll no:- 07 3rd semester  This is online E log book to discuss our patient’s de-identified health data shared after taking his/her/guardian’s signed informed consent. Here we discuss our individual patient’s problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs.This e-log also reflects patients centered learning portfolio. Case scenario   A 49 yr old female patient came to opd with the chief complaints of Shortness of breath(SOB) -grade IV and worsening  History of present illness •SOB -5 to 6 months On exertion •Pedal edema and facial puffiness since 5 to 6 months •Red urine output •Fever -10 days -subside on medication-intermittent and low grade •cough with sputum since 10 days History of past illness •k/c/o Hypertension-1 yr Treatment History   Hypertension Treatment since 1 yr •Temla 40  mg tab Perso