KAVYA SREE (04 OLD BATCH) BIMONTHLY ASSIGNMENT-JULY 21

 GENERAL MEDICINE

 KAVYA SREE 04(OLD BATCH 3RD SEM)

 BIMONTHLY ASSIGNMENT-JULY

I have been given the following assignment in an attempt to read, comprehend, analyze, reflect upon and discuss captured patient centered data

This is the link of the questions asked regarding the cases:
Below are my answers to the General Medicine Assignment based on my comprehension of the cases

1.QUESTION: Competency tested for peer to peer review and                                      assessment.


🟇She described her e-log in a very elaborate manner. She made it         more informative.


🟇She reviewed the e-log and gave review about different cases.


    My reviews on her e-log is as follows:👇


❃Regarding the review she made it very clear by adding pictures                     where ever neccessary.


❃She mentioned the pros and cores of the given cases.


❃She gave picturisation, prime importance and included pictures where ever     needed.


❃The case details were also mentioned and the links also.


❃She also gave the answers in her own way and her own kind of                    explanations.

 The link to her blog has been mentioned. It directed to all the blogs posted by the student. It would have been better if the link was more particular to the blog she meant to share. Anyways the blogs was very well made with a perfect sequence of history and diagnosis.


❃Her idea of pictorial represented is easy to memorise and helps the visual       learners.


❃Overall she did it very well her explanation is good.


❃She gave the points which were missing and made it clear.


❃Logging experience is also very well described. It would be better if she           could elaborate experience more. 


The reviews for the cases selected are well described. A detailed pinpoint review has been given to each particular case selected, which is helpful in easy analysis. Even though the peer reviews giving are short they are well described. There is even more possibility for more case depicting points which can be selectively described.


❃She really made great efforts.


QUESTION: 2 

 

This is the e-blog link which i made dis month. Below is the link👇


CASE LINK:   https://04kavyasreekaluvala.blogspot.com/.👈



QUESTION:3 Testing peer review competency of the examinees :

               


 

Patients with low back ache and renal failure :

AKI :

My reviews on her e-log is as follows

Positives: Regarding her blog she made it very clear with the pictures.

                Her way of explanation with the exact information and with the dates made                                everyone easy to understand properly.

Negetives: Diagnosis is not mentioned.



Acute on CKD :


My reviews on her e-log is as follows

POSITIVES: Regarding her blog the case which she made have complete details.
                        She made point to point discription.
NEGETIVES: Just wanted to be little bit creative regarding the presentation
                Discharge summary should have been provided

CKD :


My reviews on her e-log is as follows

POSITIVES :overall presentaion is good.

NEGETIVES :No negetives.

Patient with coma and renal failure  :



My reviews on her e-log is as follows

POSITIVES: Regardings her e-blog she made it very beautiful presentation by adding the pictures.

NEGETIVE: No negetives.



My reviews on her e-log is as follows

POSITIVES: Perfectly explained edema case.
                 Beautifully expained with vedios.
                 Explained with detailed points.

NEGETIVE: Could be more creative.



Patients with acute on CKD :


My reviews on her e-log is as follows.

POSITIVES: Regarding her blog, her explanation gives a perfect information.
                     she gave the perfect explanation of changing colouration of the urine samples.

NEGETIVES: not found any kind of negetives in her blog.


My reviews on her e-log is as follows.

 POSITIVES: Presentation is good ,neatly explained.

NEGETIVES: Can do better by adding some more pictures.



My reviews on her e-log is as follows.

POSITIVES: Completely explained blog.
                     Pictures are very well explained.

NEGETIVES: No negetives found.


Patients with AKI :


My reviews on her e-log is as follows.

POSITIVES: Detailed explanation about the patient.
                         Presentation is done very well.
NEGETIVES: Can be more creative.


My reviews on the below mentioned blog

POSITIVES: Done nicely.

NEGETIVES: The presenter name is not mentioned and the blog can be more explained.


My reviews on her e-log is as follows.

POSITIVES: Detailed explanation blog.
                       point to point explanation is given my her
                       Her own explanation is also given.

NEGETIVES: Little bit more creative can be done.

QUESTION 4:

Case 1 


COMPLAINTS:

  • weak back , after weight lifting 
  • Patient had sudden onset of pain in abdomen 
  • By burning micturation with high fever : grade associated with chills and rigor 
  • Decrease urine output associated with SOB (grade -4)
  • With no H/O chest pain, palpitations, pedal oedema, facial puffiness.

the patient has bacterial infection assosiated with burning micturition.

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
                                 |
                             2.25gm IV/ TID
4)INJ     PANTOP 40mg  IV/OD
5)INJ     THIAMINE  1AMP  IN  100ml  NS   IV/TID 


Case 2 

Acute on CKD :



COMPLAINTS:

  • 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 . 

The patient has hyperurecemia secondary to renal failure.



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 

CKD :



COMPLAINTS:

  • fever
  • generalised weakness
  • facial fluffiness and yellow discolouration of stools 
  • muscle aches and is taking NSAIDs
the patient has mutiple myeloma according to the investigations

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 

Patient with coma and renal failure  :


COMPLAINTS:

  • 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.
The patient has diabetic ketoacidosis with renal failure

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 

Patient with coma and renal failure  :

DiagnosisINFECTIVE 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 

 Patients with acute on CKD :



COMPLAINTS:

  • Fever since 4 days
  • Pus in the urine
The patient has diabetic nephropathy with anemia. had also undegone TURP.





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


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



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 

Patients with AKI :


COMPLAINTS:

  • loose stools since 20 days
  • Pedal edema since 20 days
  • Abdominal distension since 20 days
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  



Diagnosis: Acute Kidney Injury secondary to Urosepsis
Treatment:
 Inj LASIX 40mg (8am- 2pm -8pm)
IVF - NS @ UO + 50 ml/hr




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

⇛During the span of 2months I K.KAVYA SREE have experienced and seen many cases which are really helpful in clinical way. I have learned many things during the posting session .Even i have got a chance to log for a case the experience was quite helpful for me in understand how the system works. The General medicine department has done a quite a good work in making us understand the subject. For every clinical case they have guided us how to study and analize the case. I have learned how to capture the patient centered data for diagnosing the disease. I have got a chance to see the many types of investigations done in order to diagnose a disease. I am grateful for this opportunity to involve in these study.

           This is helping us learn despite not being with the patient. It gives us an understanding on history taking and how to understand the investigations and come to a conclusive diagnosis. It gives us a knowledge of various aspects of medicine. We have also learnt to respect the privacy of the patient and that we should never expose the patient information. It teaches us that even tiny details play an important role in diagnosis of the disease. Personal history is important for giving the right treatment without causing any side effects to the patient. I hereby look forward to learning more about this and hopefully one day will be good enough to provide the right diagnosis and treatment for the patient..

THANK YOU FOR GIVING ME THE OPPURTUNITY

K.KAVYASREE

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