GENERAL MEDICINE ASSIGNMENT

July,03,2021

 NAME: K.ROHIT

ROLL NO: 54 

BATCH: 2019

We have been given 5 questions as an assignment to  analyze, assess, understand and write the preview of the cases

QUESTION 1:

1.PULMONOLOGY

CASE LINK: https://aitharaveena.blogspot.com

Insights:-  A55 yr old female patient came to the hospital with chief complaints of shortness of breath, pedal edema, and facial puffiness.

The evolution of symptomatology was greatly explained with a beautiful flowchart and the mechanisms of each drug are presented briefly. Even the probable consequences which occur during the treatment are mentioned which was very informative.

2.NEUROLOGY

CASE LINK:https://blendedasessmentmadhukumar.blogspot.com

Insights:-A 40 yrs old male  with complaints of irrelevant talking and decreased food intake since 9 days 

The etiology of the case was presented concisely. The withdrawal effects were clearly presented. Episodes of seizures are mentioned on the precise timeline. It was very impressive mentioning the treatment for the ulcers occurs during the treatment.

3.GASTROLOGY 

CASE LINK: https://31nehareddy.blogspot.com/

Insights:-This the case of 33yr old male with pancreatitis, pseudocyst, and left bronchopleural fistula.

The evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patient's problem was clearly explained. It was knowledgeable for showing the malecot drain for pseudocyst and peripancreatic fluid. And interestingly mentioning the cough bubble sign on ICD suggestive pf bronchopleural fistula.

4.CARDIOLOGY

CASE LINK: https://divyasree1999.blogspot.com/?m=1

Insights:-A 78-year-old male with shortness of breath, chest pain, B/L pedal edema, and facial puffiness

The etiology of the case was presented nicely. The questions answered were reasoning proof and were brief. The images and videos used were very helpful which make us easy to understand the case. Each and every investigation were comprehensively explained. 

 

5.NEPHROLOGY 

CASE LINK: https://gsuhithagnaneswar.blogspot.com/?m=1

Insights: It is a case of 52yr old male who came to the OPD with the chief complaint of fever for 4 days and pus in the urine 

 And was diagnosed with renal AKI secondary to urosepsis with b/l hydroureteronephrosis with K/c of DM-2 since 5 yrs with diabetic nephropathy with anemia secondary to CKD with grade 1 bedsore. 

The patient's case history is mentioned perfectly with the timeline. The questions answered were precise and informative. clinical investigations are mentioned clearly with the images.

                                                              pus in the urine

6.INFECTIOUS DISEASES 

CASE LINK: https://prietyarlagadda.blogspot.com/ 

Insights:-[ Mucormycosis, ophthalmology,otorhinology, neurology.]

mucormycosis(black fungus)

50 yrs male came to the OPD with chief complaints of fever for 10 days, facial puffiness and periorbital edema since 4 days, and altered sensorium since 2 days

The questions were answered with reasoning information. Events of timeline and evolution of symptomatology were briefly mentioned in short. mentioning the primary etiology of mucormycosis and the additional medical education regarding pandemic times was impressive.

7. HEPATOLOGY 

CASE LINK: https://160vasistamadhavareddy.blogspot.com/

Insights:- liver abscess 

A 55 yr old male patient came to the OPD with chief complaints of pain abdomen since one-week

decrease appetite for one week and fever for 2 days.

The case was explained clearly based on events of the timeline. Each every detail of the case was mentioned specifically with detailed reports and images. 

                                                            liver abscess aspirate

8.NEUROLOGY 

CASE LINK: https://marisatejaswini.blogspot.com/

Insights:-This is a case of 52 yr old male with cerebellar ataxia

In this case, the questions were answered very clearly and the mechanism of drugs was better to understand. mentioning the adverse effects of alcohol abuse was interesting

9. PULMONOLOGY 

CASE LINK: https://143vibhahegde.blogspot.com/

Insights:- I find that all the symptomatology is well explained clearly. This helps in the identification of the particular problem. The etiology and anatomical location of the problem are well identified and mentioned. The flow charts and diagrams included made it easy to assess the case.

10.CARDIOLOGY 

CASE LINK: https://tejasreekandregula.blogspot.com/

Insights: The provided information was very reasonable and the indications and contraindications were mentioned clearly, it is very comprehensively explained as flow charts and diagrams were included. 

QUESTION 2

Still didn't get a chance to do a case E log. Once it's completed shall update it here.

QUESTION 3 &  4

ABDOMINAL:

Acute kidney injury secondary to Urosepsis 

Case link:https://casescape.blogspot.com/

A 60 yr old female presented to the OPD with chief complaints of pedal edema for 10 days, decreased urine output since 10 days, and fever since 10 days 

The patient was apparently asymptomatic 5 years back following her was diagnosed with diabetes mellitus type 2 on check-up and on teneligliptin 20 mg . 2 years ago she developed fever, shortness of breath, and pedal edema, and diagnosed with acute kidney injury secondary to urosepsis and resolved conservatively after dialysis.

Now presented with a history of fever, high grade since 10 days, not associated with vomiting and loose stools. patient complaints pedal edema bilateral and pitting type, with decreased urine output and burning micturition.

outside reports of her suggest acute kidney injury. Known case of diabetes mellitus since 10 years and on teneligliptin 20 mg and not known case of hypertension, bronchial asthma, and tuberculosis.

Investigations ordered:

Complete urine picture, ECG, ultrasound, serum creatinine, Blood sugar fasting, blood sugar Random, blood urea, serum electrolytes, urinary potassium, chloride and sodium, Haemogram, ABG, and bacterial culture and sensitivity report.

Diagnosis: Acute kidney injury to secondary to urosepsis with hyperkalemia (resolved)

Treatment:

Inj LASIX 40 mg IV/TID   1-1-1

IVF-NS @UO + 50ml/hr 

Inj MAGNEXFORTE 1.5gm/IV/BD

Tab NODOSIS-XT PO/OD 

Inj HAI s/c 

Neb plain asthalin 2 respules QID

BP/PR/SO2/Temperature monitoring

 

QUESTION 5

We have entered into 3rd semester 2months ago. We were excited as well as quite nervous that we are going to experience the hospital atmosphere for the 1st time, But because of the pandemic our academics and clinical postings were affected. Although the online classes were quite turbulent in the starting because of our Professors, slowly everything started falling into place. And even the clinics are going on perfectly because of the efforts of our Professors in helping us understand the cases thoroughly. And finally, I would like to convey my special thanks to the department of general medicine for encouraging us day by day to improve our knowledge!