BIMONTHLY BLENDED ASSIGNMENT OF MEDICINE ---JUNE 2021
NAME : G.PREETHI REDDY
ROLL.NO : 43
BATCH:2019 (3rd SEM)
QUESTION 1 :
1.PULMONOLOGY
PATIENT DETAILS:
REVIEW:
A patient came to the opd with the chief complaints of fever ( past 10 days ) and dry cough (past 3 days) and shortness of breath since one day . He had a HRCT which showed CORADS IV and severity score of 3/25 .He has been diagnosed as VIRAL PNEUMONIA .The patient was treated with O2 inhalation to maintain spo2 above 90%. He has been monitored for 4 days with certain medications and discharged successfully after 4 days of treatment.
2.NEUROLOGY
PATIENT DETAILS:
REVIEW :
This is case of Wernicke's encephalopathy secondary to chronic alcohol dependence. and, uraemic encephalopathy and alcohol withdrawl delirium .The patient came with chief complaints of irrelevant talking and decreased food intake since 9 days .he has 2-3 episodes of seizures and diabetes from past 2 years for which he has been taking tablets irregularly .The treatment outlined all required medications to resolve all the presenting symptoms and underlying causes to the greatest extent possible and recovery will depend on the patients adherence to the treatment regimen.
3.CARDIOLOGY
Patient details :
Review:
This is the case of acute coronary syndrome . The patient came to the opd with complaints of shortness of breath since 1\2 hour and heart burn from past one year which relived without use of any medication and she has been diagnosed with tb for which she completed course of medication a month ago. Her ecg shown depressed ST wave, no progression to Qwave and partial blockage of coronary artery The patient was then taken to another hospital, for further treatment but PCI was not done as there were no vacancies in hospitals at that time. The patient was discharged after that and is currently doing fine.
4.NEPHROLOGY AND UROLOGY
PATIENT DETAILS :
REVIEW :
Patient came to the opd with the chief complaints of fever since 4 days and pus in the urine .He was diagnosed with type 2 diabetes and on treatment Tab GLIMI M1 and goes for regular checkup .Patient has burning micturition and diagnosed with prostomegaly and TURP. 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 bed sore. The patient has been investigated well and treated with medication required.
5.Infectious diseases (Mucormycosis, ophthalmology, Otorhinolaryngology)
PATIENT DETAILS :
REVIEW:
This is the case of altered sensorium .Primary etiology in this case was fungal infection with mucor and anatomical location is rhino orbital cerebral disease .Patient presented to the casuality with the symptoms of facial puffiness and periorbital edema and he was also diagnosed with diabetes mellitus ,the patient was referred to Osmania general hospital but the patient is no more as there is no availability of medicine
6.GASTROENTEROLOGY
PATIENT DETAILS:
REVIEW:
This is the case of acute pancreatitis ,pseudocyst and broncho pleural fistula .The patient came to the opd with chief complaints of pain abdomen and vomiting since 1 week and constipation,burning micturition ,fever since 4 days. abdominal pain is noticed in umbilical ,left hypochondric,left lumbar and hypogastric regions and it was incresed after food intake .Investigations were done well and the patient treated with respective medications and finally patient discharged.
7.SEVERE COVID WITH DIABETES
PATIENT DETAILS :
This is the case of viral pneumonia secondary to covid-19 infection .The patient came to the opd with the chief complaints of fever,dry cough,generalised weakness,difficulty in breathing Despite all the above measures, on day 4 of hospital stay the SPO2 levels kept falling, pulse was not recordable. ECG has shown a flat isoelectric line and the patient was declared dead.The immediate cause of death is cardio pulmonary arrest
8.INFECTIOUS DISEASE AND HEPATOLOGY
PATIENT DETAILS :
REVIEW :
This is case of LIVER ABSCESS .A patient who is a tree climber by occupation came to opd with complaints of abdominal pain,loss of appetite and fever .the amebic liver abcess is confined to adult males who consumes locally brewed alcohol .The patient was given antibiotic treatment and when gastro opinion was taken pigtail catheterisation adviced but was not as abcess was not drainable .and the patient was discharged and is on weekly follow up .
9.INFECTIOUS DISEASE( HI Virus, Mycobacteria, Gastroenterology, pulmonology )
PATIENT DETAILS :
REVIEW :
A Patient came to the opd with chief complaints of difficult in swallowing , fever and cough. She is diagnosed with RVD since 2 months on ART with dysphagia secondary to esophageal candiasis. She has been on ANTI RETRO VIRAL treatment At present there are no vaccine or cure for treatment of HIV Infections. But these ART suppress HIV infection before complications can be occur and proved to be useful in prolonging life of several ill patients.
10.CARDIOLOGY
PATIENT DETAILS :
REVIEW :
This is the case of ATRIAL FIBRILLATION AND BIATRIAL THROMBUS.The patient came to the opd with the chief complaints of decreased urine output and shortness of breath at rest since one day. Patient is also diagnosed with cardiac renal syndrome type 4.investigations were done in detail .the patient has been treated with respective medications and has got discharged .
QUESTION - 2
I haven't got the chance to make a case report yet.
QUESTION - 3
This is the case of ACUTE KIDNEY INJURY SECONDARY TO UROSEPSIS .A patient presented with chief complaints of n pedal edema and decreased urine output . The patient was already diagnosed with DM2 .After she diagnosed with acute kidney injury secondary to urosepsis and it got resolved conservatively after dialysis .All the investigations like complete urine examination ,ECG ,Ultrasound is done.ABG Analysis is also done . Bacterial and sensitivity report and Complete Blood Picture is done .The case is very well presented and daily update on her blood and urine analysis is also given .This was treated with the Inj LASIX 40 mg IV/TID and IVF - NS @ UO + 50 ml/hr and other necessary medications were given to relive her symptoms and for the good recovery.
QUESTION - 4
This is the case of HFrEF with ATRIAL FIBRILLATION .The patient had chief complaints of abdominal distension and shortness of breadth . She is a known case of hypothyroidism since 5 years and she has no history of palpitations ,Pedal edema ,oliguria ,fever cough ,fatigue .She was on thyronorm 100mg OD for hypothyroidism .Her troponin - 1 is negative.The investigations done in the case are complete blood picture ,serum electrolytes HIV 1/2 rapid test ,glycated Hb ,CRP, blood sugar random and 2D echo is also done . By seeing her biochemical report we can say that she is suffering from severe hyperthyroidism possibly relating to her Atrial Fibrillation and attempted for Defibrillation but unfortunately she had
passed away.
QUESTION - 5
Testing scholarship competency in logging reflective observations on your concrete experiences of this last month
As I am new to clinical postings ,I am very excited to take up the case . writing the review analyses the content and make us update . But due to this pandemic we are unable to appear directly and experience the patient but it is made possible by our HOD of general medicine Dr. Rakesh Biswas sir by teaching every single aspect regarding capturing the patient centered data. I thought its impossible to learn through online but surprisingly I have got to learn a lot through online also. we have created a group where we get the cases taken up by the interns and pgs. The cases being discussed and updated till the discharge of the patient.
It feels accomplished and great to have experience of taking history of patient in 3rd semester itself and understanding what, why and how disease is being caused . this questions makes us curious to learn about clinical subjects more efficiently. Sharing knowledge with our peers and interacting with them regarding the cases has helped so much. This has been a wonderful opportunity to interact with the peers .The E-Logs which has been kept for us are useful and made me learning so many things. once again thank you for giving me this opportunity.
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