GENERAL MEDICINE BIMONTHLY ASSESSMENT
JULY 2021
Shwetha Mummadi
Roll no.: 87
QUESTION-1:
Competency tested for Peer to peer review and assessment :
Please go through one student's entire answer paper from this link, the one who is closest to your own roll number :
I Have gone through the previous assignment of Roll no.85 Varshith and briefly reviewed all his answers.
Here is my review:
Question-1
Firstly His case selection is impressive.
He selected the cases under each system which is very good.
Review given by him is an overall review i.e, He have not given review specifically for each question.
His review was well but precise.
Therefore,what he had done is good and decent.
Question -2
He had done blog on case of MULTIPLE LIVER ABCESS.
good attempt and well presented.
All the required data is provided in his blog.
Treatment details are also collected day to day.
Questions 3&4:
He gave a clubbed answer for both 3&4 questions.
Case was keenly studied and answered well.
Included provisional diagnosis, treatment history day to day and also investigations done of the case.
But his critical appraisal was very precise.
Overall clear and good.
Question-5
Gave his genuine opinion on telemedical learning and Elogging.
QUESTION -2:
Share the link to your own case report of a patient that you connected with and engaged while capturing his her sequential life events before and after the illness and clinical and investigational images along with your discussion of that case.
I didn't got a chance to do any case blog yet.
QUESTION-3:
provide your critical appraisal of the captured data in terms of completeness, correctness and ability to provide useful leads to analyze the diagnostic and therapeutic uncertainties around the cases shared.
1. https://laharikantoju.blogspot.com/2021/07/58-year-old-male-patient-elog-lahari.html?m=1
Critical appraisal:
chief complaints :
- lower abdominal pain: 1 week
-burning micturation:1week
- low back ache after lifting weights
-dribbling / decrease of urine out put:1week
-fever :1 week
- SOB , rest :1week
History of present illness :
H/O NSAISD use present, Regularly for body pains and headache
-No photo phobic, phonophobia , giddiness nausea, vomiting, tinnitus
- blurring of vision, black outs
History of past illness :
RTA 13 years, trauma to head , CT brain
Shows minimal bleed - used medication for 3 months
K/C/O - HTN: 1 year (not on medication)
N/K/C/O- DM-2 ,TB, epilepsy ,CNA ,CAD
Review:
Case was ACUTE RENUL INJURY Which is easy to understand.
History taking is clear.
Treatment history has been clearly mentioned.
Personal history is also adequately provided
2. http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html
Critical appraisal:
Chief compliants:
• Lower backache since 10days
• dribbling of urine since 10days
• Pedal edema since 3days
• SOB at rest since 3days
• Increased involuntary movements of both upper limbs since 10days .
Review:
Case was presented in a simple manner made it easy to comprehend.
All the diagnostic investigations are placed in a sequence which is very useful for case study.
Also under treatment,the day to day treatment history is added which reflects the work of reporter and it is appreciable.
3. https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1
Critical appraisal:
Cheif compliants:
- Since 3 yrs she has history of muscle aches, for which she is using NSAIDs.
- She has h/o fever 20 days back, got treated in the local hospital, and
- Since 20 days she has generalized weakness.
- She also has h/o vomitings since 3 days, with food as content, non - projectile , non bilious.
- Urine output - Normal
- No fatigability , pedal oedema ,
- No SOB , facial fluffiness , yellowish discoloration of stools
Review:
Presentation was neat and easy to follow.
Information provided is concise clear and to the point.
Family history is not available in the blog if provided we can know whether her marriage is consenginous or not.
Systemic examination is thorough.
4. https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html
Critical appraisal:
It was a case of coma and renal failure.
Chief compliants:
Patient came with
- Fever and Diarrhea since 5 days( 4 to 5 times a day with blood discharge).
- Back pain( 5 days ago) with abdominal pain and chest pain
Review:
Case was Clearly described.
The information provided has been put as required.
History taking is very clear and appropriate
That lead the cause towards making of accurate and timely provisional diagnosis.
Overall keen work has been done.
Critical appraisal:
This is a case under coma and renal failure.
Chief compliants:
abdominal distension from the past 7 days.
History of present illness:
he had a non healing injury to the right foot which raised a suspicion of Diabetes mellitus. Then they went to neatest medical care and diagnosed with Diabetes mellitus type 2 and was started on Tab. GLIMI M2 OD.
2 years back he complained of Tingling in the upper limbs up to the palms, in the lower limbs up to the knee.
15 Days back patient presented to the casualty with Abdominal Distension.
History of past illness:
Not a known case of HTN, CAD, Asthma, TB, Epilepsy, Thyroid disorders.
No history of surgeries and blood transfusions in the past.
Review:
The case was easily comprehendible.
Written in a simple and language is easy to understand.
Personal and family history has been included which is really very essential.
Overall all the necessary details are attached to blog which made it clear to assess the case.
Well covered case.
Critical appraisal:
Chief compliants:
Fever since 4 days
Pus in the Urine
Review:
Case is presented in a simple and Easily understandable manner.
Appropriate highlighting was done which made it a bit more interesting to reader.
History of present and past illness was very clear.
All diagnostic investigations are provided in an order.
Overall a well presented case.
Critical appraisal:
Chief compliants:
Shortness of Breath grade -II from the past 1 week, which converted into grade -III-IV from the past 4 days
History of presenting illness:
2yrs back - deranged RFT, Chronic renal failure
7 months back- chest pain
2 months back- shortness of breath
1week back - Short Ness of breath grade 2
4-5days back- increased to grade3&4
History of past illness:
Diabetes mellitus and Hypertension from past 7 years.
Review:
Case presentation is easy to follow and understand.
All necessary details are provided.
Investigations are also adequately provided.
Very neat and organized presentation.
Critical appraisal:
Chief complaints:
Pedal edema since 3 days.
Decreased urine output since 3 days.
H/o vomitings and loose stools 5 days ago lasted 3 days and subsided.
Review:
Information provided is concise.
Would have been presented in a point wise and also have been highlighted at least side headings
That would help the reader to differentiate the provided information under certain sections.
Critical appraisal:
Chief compliants:
- loose stools since 20 days
- Pedal edema since 20 days
- Abdominal distension since 20 days
Review:
Log was good and clear.
Present past and family history was provided.
Information collected is very useful for the understanding of case easily.
Critical appraisal:
Chief complaints:
pedal edema since 10 days, decreased urine output since 10 days and fever since 10 days.
Review:
Log was impressive.
Information was well assisted with pictures.
Treatment and diagnosis are clearly explained.
All required reports and details are provided.
Critical appraisal:
Chief complaints:
pain in abdomen since a week
Vomiting since a week
Sob since 2 days.
Review:
Log was clear and precise.
Day to day treatment have been mentioned.
Provided case summary made it easy to understand.
QUESTION-4:
✱ Case 1
Diagnosis : AKI secondary to UTI, associated with Denovo - DM -2
Treatment :
1)IVF : -RL @ UO+ 30ml/hr -NS
2)SALT RESTRICTION < 2.4gm/day
3)INJ TAZAR 4.5gm IV/TID
4)INJ PANTOP 40mg IV/OD
5)INJ THIAMINE 1AMP IN 100ml NS IV/TID
✱ Case 2
Diagnosis : Hyperuricemia 2° to Renal failure
Treatment:
• IVF - NS-0.9% @100ml/hr
• Inj. Tazar 2.25gm I.V -TID
• Inj. Lasik 40mg I.V -BD
✱ Case 3
Diagnosis: Chronic interstitial nephritis secondary to plasma cell dyscariasis
Treatment:
- T. PAN 40mg /PO / OD
- oral fluids upto 1.5 - 2 lit / day
- Protein - x ( plant based ) 2 tablespoon in 1 glass of milk
✱ Case 4
Diagnosis: DKA with AKI
Treatment:
Inj. NORAD 2amp in 50ml NS
Inj. PIPTAZ 2.25gm.
Inj. DOPAMINE 2amp in 50ml
Inj. HAI 1ml in 39ml NS
✱ Case 5
Diagnosis:INFECTIVE ENDOCARDITIS
Treatment:
1. Inj. Monocef 1gm IV/BD
2. Inj. Vancomycin 500mg IV/BD in 100ml NS over 1hr
3. Procto clysis enema
4. Inj. Pan 40 mg Iv/OD
✱ Case 6
Diagnosis: Renal AKI secondary to urosepsis with b/L hydroureteronephrosis
Treatment:
Injection PANTOP 40mg IV/OD
Injection PIPTAZ 4.5 stat and 2.25 gm IV/ TID
Injection LASIX 40mg IV/BD
Injection optineuron 1AMP in 100ml NS slow IV/OD
✱ Case 7
Diagnosis: HFrEF secondary to CAD; CRF
Treatment:
1. TAB. BISOPROLOL 5mg OD
2.TAB. NITROHART 20/37.5mg 1/2 T/D
3.TAB NICARDIA XL 30mg OD
4.TAB. GLICIAZIDE 80mg BD
5.TAB. NODOSIS 500 mg TD
✱ Case 8
Diagnosis: Acute on CKD
Treatment:
1. Tab. Augmentin 625 mg ×7 days
2. Tab. Wysolone 40 mg ×10 days.
30 mg × 10 days
20 mg ×10 days
10 mg ×10 days.
3. Tab . Lasix 20 mg × 1 month.
✱ Case 9
Diagnosis: Alcoholic Hepatitis and aki sec to gastroenteritis
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
✱ Case 10
Diagnosis: Acute Kidney Injury secondary to Urosepsis
Treatment:
Inj LASIX 40mg (8am- 2pm -8pm)
IVF - NS @ UO + 50 ml/hr
✱ Case 11
Diagnosis: pancreatitis in a chronic alcoholic
Treatment:
IV lasix 40 mg BD .
Tab Nodosis .
IV PIPTAZ 4.5 Gms. BD
Iv 25%Dextrose. 100 ml BD
Iv fluids : NS 40 ml /hr.
QUESTION-5:
Testing scholarship competency in
logging reflective observations on your concrete experiences of this last month
During this pandemic situation our faculty have been trying hard to make us get exposed to every new case
And also they are trying to engage us to transcribe the work into blogs.
All this are satisfactory.
We are been working on virtual clinical cases,with discussions through WhatsApp group,making assessments.
All though attending clinical classes through online was little difficult,but we are trying to do our best.
This telemedical learning and Elogging experience was Good, But most important thing we are missing was direct exposure to clinical postings.
Hope to attend clinicals directly in the hospital very soon.
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