General medicine - Formative assessment
Online bimonthly assignment
Singareddy Manasa
3rd Semester
Roll no. - 126
I have been given the following cases to solve in an attmept to understand the topic of 'Patient clinical data analysis' to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and diagnosis and treatment plans and to give review on the answer of the respective cases.
This is the link of the questions asked regarding the cases
http://medicinedepartment.blogspot.com/2021/05/online-blended-bimonthly-assignment.html?m=1
Question 1 :
1) PULMONOLOGY
Case :
https://anuragreddy72.blogspot.com/2021/05/online-blended-bimonthly-assignment.html
- It is a case of A 55 year old female patient, with the chief complaints of shortness of breath, pedal edema and facial puffiness.
- After going through the history of patient, doing all required examinations and investigations, the provisional diagnosis is given as Acute exacerbation of COPD associated with right heart failure and bronchiectasis.
The evolution of symptomatology of the patient is explained properly with the help of flow chart so that is easy to comprehend.
Timeline is also clearly metiontioned. Anatomical localization as well as primary etiology are clearly explained.
Mechanism of action and other details of the pharmacological and non - pharmacological interventions used on the patient are clearly described and explained along with the relevant graphs. References from various related journals are also mentioned.
Causes of electrolyte imbalance in the patient is also properly explained.
2) NEUROLOGY
Case : https://prathyushamulukala666.blogspot.com/2021/05/online-blended-bimonthly-assignment.html?m=1
- It is a case of a 40 year old male presented with the chief complaints of irrelevant talking and decreased food intake since 9days.
- After going through the history of patient, doing all required examinations and investigations by other relavent departments like psychiatry and surgery along with general medicine, the provisional diagnosis is given as Wernicke's encephalopathy secondary to chronic alcohol dependence, Uraemic encephalopathy and alcohol withdrawal delirium.
The symptomatology is not completely mentioned. Some symptoms and condition of the the patient is not completely mentioned. Anatomical localization and primary etiology are also not clearly explained.
The drugs used to treat the patient are mentioned and described by its use in treating the patient.
The other questions are also properly answered and are briefly explained.
3) Case 2b
Case : https://manasapailla.blogspot.com/2021/05/medicine-online-blended.html?m=1
- It is a case of a 52 year old male with Chief complaints of slurring of speech and deviation of mouth that lasted one day and resolved on the same day.
- After going through the history of patient, doing all required examinations and investigations, the provisional diagnosis is given as Cerebellar Ataxia secondary to Acute Cerebrovascular Accident (CVA) with infarct in the right inferior cerebellar hemisphere.
The evolution of symptomatology of the patient is explained very clearly along with proper timeline, in the chronological order. Anatomical localization and etiology are stated properly.
Mechanism of action of drugs and their efficiency are described clearly.
Other questions about his history and its effect on the present illness are explained along with references.
4) Case C
Case :
https://snehachauhan126.blogspot.com/2021/05/medicine-monthly-assessment-may-2021.html?m=1
- It is a case of a 45year old female with chief complaints of palpitations, pedal edema and radiating pain along the left upper limb.
- After going through the history of patient, doing all required examinations and investigations, the provisional diagnosis is given as cervicalspondylosis and recurrent hypokalemic paralysis.
The overall assignment was clear and presented properly. The explaintion was breif for the questions but they were asnwerd properly.
ECG changes were also mentioned.
5) Case 2E
Case :
https://143vibhahegde.blogspot.com/2021/05/medicine-blended-assignment-may.html?m=1
- It is a case of a 48yr old male with the chief complaints of unresponsiveness for 7 hours and 3 intermittent episodes of seizures in the past 3 hours.
- After going through the history of patient, doing all required examinations and investigations, the provisional diagnosis is given as Generalized tonic-clonic seizures secondary to acute hemorrhage in the frontal, temporal, and parietal lobes with a 13mm midline shift.
The document is very clear and easily distinguishable.
The reason for the development of the ataxia is beautifully explained. The role of alcoholism in the development of the disease is also clearly explained along with other patient factors.
6) CARDIOLOGY Case III
Case :
https://meghanaraomuddada.blogspot.com/2021/05/medicine-case-based-learning.html?m=1
- It is a case of a 52yr old male with the chief complaints of decreased urine output and shortness of breath at rest since one day.
- After going through the history of patient, doing all required examinations and investigations, the provisional diagnosis is given as congestive heart failure( resolved ), atrial fibrillation with rapid ventricular response, bilateral thrombosis with atrial septal defect.
💬 Review
The evaluation of symptomotology of the patient is done nicely. They were arranged in chronological order. Anatomical localization is mentioned. Primary etiology is also explained.
Mechanism of action of drugs, indication and efficiency are given along with graphs and references. Renal involvement in the heart failure is also explained clearly. Other answers were also written.
7) GASTROENTEROLOGY - Case A
Case :
https://sannithreddykasala.blogspot.com/2021/06/general-medicine-blended-assignment.html?m=1
- It is a case of a 33yr old male with chief complaints of pain abdomen & vomiting since 1 week and constipation, burning micturition, fever since 4 days.
- After going through the history of patient, doing all required examinations and investigations, the provisional diagnosis is given as chronic pancreatitis with pseudo cyst and left pneumothrax.
💬 Review
The symptomatology, anatomical localization and primary etiology are briefly mentioned along with the investigational findings.
The drugs used are described clearly along with their uses and actions on the body. It was clear and easy to understand.
8) NEPHROLOGY - Case A
Case :
https://makkenavarsha76.blogspot.com/2021/05/general-medicine-assignment-i-may.html?m=1
- It is a case of a 52yr old male patient with chief complaints of fever since 4 days and pus in urine.
- After going through the history of patient, doing all required examinations and investigations, the provisional diagnosis is given as acute renal failure secondary to urosepsis with bilateral hydroureteronephrosis with diabetic nephropathy
💬 Review
The questions were answered and explained clearly with the help of diagrams and investigation reports where ever necessary. The answers were brief but understandable. References to support the given answers were also mentioned.
9) HEPATOLOGY Case - A
Case :
https://41srujini.blogspot.com/2021/05/medicine-blended-assignment.html?m=1
- It is a case of a 55yr old male patient with chief complaints of pain in abdomen and decrease in appetite since one week and fever since two days.
- After going through the history of patient, doing all required examinations and investigations, the provisional diagnosis is given as liver abscess.
💬 Review
The overall document is not very clear. Everything is not easily distinguishable. It was hard to understand. The questions were answered properly but all answers were briefly written.
10) CARDIOLOGY Case 5
Case :
https://15abhishek.blogspot.com/2021/05/15-cabhishek-general-medicine-assignment.html?m=1
- It is a case of a 60yr old male patient with chief complaints of chest pain since three days and giddiness and profuse sweating since morning.
- After going through the history of patient, doing all required examinations and investigations, the provisional diagnosis is given as inferior wall Myocardia infraction with uncontrolled sugars with known complain of diabetes mellitus since 8 yrs.
💬 Review
The symptomatology, anatomical localization are briefly mentioned. Primary etiology is explained.
All the administered drugs and angioplasty are clearly explained. Overall the document was written in such a way that it is easy to understand.
Question 2 :
⭐ Sir I didn't yet get the opportunity to do an E-log for a case. Once its done, I will upload it here.
Question 3 & 4 :
It took the following case to answer these questions.
Case :
https://nikithaedam48.blogspot.com/2021/06/18-year-old-malefrom-miryalagudawho-is.html
➡ It is a case of an 18yr old male. He presented to the hospital with chief complaints of low backache which was apparently one week ago. Other Chief complaints include fever since 5days, yellowish discoloration of scelera since 3 days and 2 episodes of vomiting, 3 episodes of loose stools and blood tinged urine yesterday morning.
➡ History of present illness shows that the patient has polyuria, nocturia and polydypsia since 2 months. Nausea is present. Loss of appetite and burning micturition is present.
➡ Past history, personal history and family history are taken. General examination is din and the vitals are recorded.Systematic examination of CVS, Respiratory system and abdomen are done. It revealed tenderness in the right hypochondrium and left epigastrium.
➡ Relevant investigations are done and the provisional diagnosis was given as acute viral hepatitis, De novo diabetes mellitus type 1 and diabetes ketoacidosis.
➡ The patient was given medication based on the investigations and clinical findings. On fourth day the patient became drowsy and was not responding to verbal comands but was responding to painful stimuli. Due to futher investigations like brain CT are done.
➡ The patient was kept on follow up was treated based on the clinical findings. He showed positive After nearly 16 days of treatment he was discharged in conscious, coherent and cooperative condition. He was given the required medicines to taken at home along with a deltail about food intake.
➡ His condition kept changing from time to time and new investigations were done upon requirement and medication was changed depending on the results. Finally the patient was cured and discharged.
Question 5 :
In competency based medical education reflection reflective logging of ones own experience is very important.
We completed our 1yr exams and the lockdown started due to rapid increase of the covid cases in our country. We felt very sad because our 2nd year was going to online. We thought that once second year starts we can go to hospital and see live patients and learn from professors and seniors when they treat the patient. Due to online classes we felt bad that it was not going to happen.
But once the online classes stsrted our professors and seniors doing their best in helping us understand the cases. They made it feel like we are not missing much due to online classes, by live video sessions with the patients.
First we not able to understand properly but as the classes progressed we learnt to take history of the patient and we learning how to corelate what we learn in the first year and what we learning now like the reason behind prescribing the particular drug for a patient with particular disease by correlating general medicine with pharmaology.
Now due to this assignment we got an idea about E-log and something or the other from various cases. As we do more of them we keep learning more. We learning all this by telemedicine but one day we wish to learn directly in wards. Hope that day comes soon.
I want to that Rakesh sir, other professors, PGs and interns of general medicine department for this providing wonderful opportunity and for helping by teaching us how to utilize it.
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