68 Naga Meghana

 Bimonthly blended assessment july 2021

I have been given the following cases to solve in an attempt to understand the topic of 'patient  clinical data analysis' to develop my competency in reading and comprehending clinical data including history,clinical findings, investigations, diagnosis and treatment plans.

Link to following cases :

https://generalmedicinedepartment.blogspot.com/2021/06/bimonthly-formative-and-summative_19.html?m=1

Below are my answers to the given  assessment bases on my comprehension of the cases.

Question 1

https://67sailikhitha.blogspot.com

Elog prepared for different cases was very brief, understandable ,clear and very well presented.The assessment done on each case was appropriate and given detailed information on each case.In every aspect of case the information provided was easy to comprehend the details and clinical findings .The diagnosis of each case is clearly mentioned and the presentation is excellent.overall the assessment done on each case is appreciated.

Question 2:

I haven’t got a chance to do case report yet.

Question 3 and Question 4:

https://laharikantoju.blogspot.com/2021/07/58-year-old-male-patient-elog-lahari.html?m=1

Patient with acute kidney injury 

He visited casualty due to complaints of lower abdominal pain ,burning micturition and low back ache after lifting weights.

He diagnosed with acute kidney injury secondary to UTI associated with DM-2.

The blog prepared Was not clear.several investigations were done and pictures of those are depicted,but the cause of sudden back ache after lifting weights was not shown.

Treatment:

SALT RESTRICTION  < 2.4gm/day

INJ    TAZAR     2.25gm IV/ TID

INJ     PAN TOP 40mg  IV/OD

INJ     THIAMINE  1AMP  IN  100ml   NS   IV/TID

TAB.   PCM   500mg    PO/ SOS

INJ     HAI  S/C  ACC  TO   SLIDING SCALE

INFORM  GRBS 

GRBS  - 6th Hourly

 BP/PR/TEMP - 4th Hourly

I/O - CHARTING (STRICT)

T. ULTRACET  PO 1/2 TAB  QID

http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html

Patient with acute on CKD

 

He visited casualty with lower backache,pedal edema,shortness of breath,dribbling of urine.

He diagnosed with acute renal failure( intrinsic),hyperuricemia secondary to renal failure.

The blog presentation is appreciable.all the investigations done to the patient were shown and examinations are done properly.Treatment given to the patient on the daily basis is shown clearly.

Treatment:

IVF -    NS-0.9%  @100ml/hr

• Inj. Tazar 2.25gm I.V -TID 

• Inj. Lasik 40mg I.V -BD 

•Nebulization Salbutamol -4th hourly 

• Inj. Pantop 40mg I.V -OD 

• Tab. PCM 650mg -TID 

• Foleys catheterization 

• Temperature ,Bp, PR Charting  hourly 

• Strict IO Charting

•GRBS -12th hourly 

• Inj.25% D with 10units of insulin IV -slow for 1hr 

https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1

Patient with CKD

Patient visited hospital as she noticed mass per annum with bleeding,diagnosed as haemorrhoids,operated.

Diagnosis was Chronic interstitial nephritis secondary to plasma cell dysacariasis.

The blog clearly depicted the bone marrow aspiration by which the diagnosis was made.several investigations required were  done and xray pictures were also shown.electrophoretic pattern clearly depicts multiple myeloma,pathologic patterns were depicted which is useful for diagnosis.

Treatment:

T. PAN 40mg /PO / OD

- oral fluids up to 1.5 - 2 lit / day

- Protein - x ( plant-based ) 2 tablespoons in 1 glass of  milk  

- Donot give IV fluids unless instructed

- T. ZOFER 4mg / PO / SOS

- Evaluate Anaemia start Iron Supplementation (oral ) after Gastritis ( (resolved )

- TAB NODOSIS  550 BD

https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html

Patient with coma and renal failure

Patient was admitted with complaints of fever ,diarrhoea,bed sores,back ,chest and abdominal pain,breathlessness and known case of DM-2.She is unconscious when admitted.

Diagnosis is DKA with AKI.

The blog presentation was very appreciable.the pictures of bed sores are shown daily as the treatment is going on and examinations are done carefully and depicted clearly.treatment plan and investigations done regularly are nicely depicted.

Treatment:

Inj. NORAD 2amp in 50ml NS

Inj. PIPTAZ 2.25gm.

Inj. DOPAMINE 2amp in 50ml

Inj. HAI 1ml in 39ml NS

 Inj. CLEXANE 40gm. 

Iv infusion NS RL @100ml/hr.

Inj. LEVOFLOX

https://kavyasamudrala.blogspot.com/2021/05/medicine-case-discussion-this-is-online.html?m=1

Patient with acute on CKD.

Patient visited hospital with complaints of fever and pus in urine.in the past patient had burning micturition and diagnosed as prostomegaly,advised TURP.due to various problems he used to visit hospital .He Is known case of DM-2 .

Diagnosis is renal AKI secondary to urosepsis ,diabetic nephropathy with anemia secondary to CKD.

The blog presentation is good.The investigations were shown .The history of patient visiting hospital was clearly depicted but the treatment plan may be more brief on the daily basis.

Treatment:

Injection PAN TOP 40mg IV/OD

Injection PIPTAZ 4.5 stat and 2.25 gm IV/ TID

Injection LASIX 40mg IV/BD

Injection optineurin 1AMP in 100ml NS slow IV/OD

Injection NEDMOL 100ml IV/SOS

Tab PCM 650mg TID

Insulin Human actrapid - 16 IU/TID

httpts://keerthireddy42.blogspot.com/2021/07/43-yr-old-male-of-nalgonda-came-to.html?m=1

Patient with AKI

Patient visited with complaints of loose stools,pedal edema,abdominal distension.

Diagnosis is alcoholic hepatitis,AKI secondary to acute gastroenteritis.

The blog presentation was clear.Day wise investigation , treatment and observations are clearly depicted.

Treatment:

INJ THIAMINE 100 mg in 100 ml NS slow IV / TID

INJ OPTINEURON 1AMP in 100 ml NS slow IV / OD

INJ LASIX 40 mg

TAB. ALDACTONE 50 mg PO / BD

INJ PAN TOP 40 mg IV/ OD

ABDOMINAL GIRTH MEASUREMENT DAILY

BP /PR/TEMP/ RR -4 hourly 

I/O CHARTING

Question 5:

Due to this pandemic, we are unable to appear directly and experience the patient but even though we had a very good experience which is not had been possible without the general medicine department. Dr. Rakesh Biswas sir, HOD made it possible by teaching every single aspect regarding capturing the patient-centered data.

We've got to learn a lot online too. As our college has created a group where we get all the cases taken up by interns and pgs and is being discussed and updated till the patient gets discharged. It feels accomplished .

It's great to have experience of taking the history of the patients admitting to our hospital in the 3rd semester itself and understanding why and how the disease is being caused. 

These questions are making us curious to learn clinical subjects more efficiently.

 We have learned how to take the history and data from a patient to communicate and diagnose the problem.

This paved a way for learning new things differently. 

Sharing knowledge with our peers and interacting with them regarding the cases has been so helping full to us. 

This has been a wonderful opportunity to interact with my peers. 

The E logs which have been kept for us are helpful and made me learn so many new things.