04 KAVYASREE KALUVALA OCT 24TH
Oct 2021 formative bimonthly blended learning assignment
OCTOBER-24th
Q1) (Testing peer review competency in the active reader of this assignment) :
Please go through the case reports in the links shared above and 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.
Gastroenterology :
(Captured by 2018 batch student final year MBBS):
The document is well listed but could have been enhanced with the help of diagrams and highlighting the important points. the content of the document is explained well in a language that is easy to understand. the readability of the document could have been increased .
(Captured by 2017 batch student final year MBBS):
The case has been presented very clearly and to the point . All the data pertaining to the case has been provided .
(Captured by 2016 batch intern post final year mbbs) :
The entire document is very well-formatted, the organization of the data makes it very easy to look through.
Symptomatology has been given in chronological order.
CNS :
(Captured by 2016 batch intern post final year mbbs) :
The data provided is correct . But lack the discharge summary.
(Captured by 2017 batch student final year MBBS):
The presentation was neat and informative.
The symptomatology could have been expressed in a better way.
(Captured by 2016 batch intern post final year mbbs) :
The document is well listed.
Important points could have been highlighted.
The presentation is very impressive. The information provided is correct.
(Captured by 2017 batch student final year MBBS):
the content of the document is explained well in a language that is easy to understand. the readability of the document could have been increased .
(Captured by 2016 batch intern post final year mbbs) :
All the data pertaining to the case has been provided .
Hematology :
(Captured by 2016 batch intern post final year mbbs) :
Symptomatology has been given in chronological order.
Pulmonology, Cardiology :
The entire document is very well-formatted, the organization of the data makes it very easy to look through.
Nephrology :
(Captured by 2018 batch student final year MBBS):
The document is well listed but could have been enhanced with the help of diagrams and highlighting the important points.
Q2: and Q3: Testing scholarship competency of the examinees ( ability to read comprehend, analyze, reflect upon and discuss captured patient centered data):
Please analyze the above linked long and short cases patient data by first preparing a problem list for each patient in order of perceived priority (based on the shared data) and then discuss the diagnostic and therapeutic uncertainty around solving those problems.
Include the review of literature around sensitivity and specificity of the diagnostic interventions mentioned and same around efficacy of the therapeutic interventions mentioned for each patient.
Answer
Gastroenterology :
(Captured by 2018 batch student final year MBBS):
Problem list:
History of low grade fever, intermittent, not associated with chills and rigor.
Patient also complaints of yellowish discoloration of urine since 1 month, passing of clay colored stools since 1 month.
He also complaints of itching all over the body since 1 month, decreased appetite, loss of weight and generalised weakness since 1 month
Diagnostic approach and treatment
Antibiotic therapy (if indicated for infection)
- Endoscopic retrograde cholangiopancreatography (ERCP),
- Intravenous fluids and pain medications
(Captured by 2017 batch student final year MBBS):
Problem list: * History of pedal edema, in both lower limbs since 10-15 days which is incidious in onset and gradual in progression and worsened to the present size.
* History of abdominal distension, since 10-15 days which is progressively increasing.
* Endoscopy was done and grade 1 varices are present and ultrasound showing mild splenomegaly.
* History of decreased urine output since 10-15 days, with normal stream & post voidal residue with urgency and hesitency present
Diagnosis
CHRONIC LIVER FAILURE
&
HEPATO RENAL SYNDROME OR
CHRONIC KIDNEY DISEASE ??
(Captured by 2016 batch intern post final year mbbs) :
Problem list:
on 15th Feb 2021 isg abdomen
IMPRESSION:
1)Post cholecystectomy status with mildly altered texture of hepatic bed at gall bladder fossa region & prominent bilobar IHBR.
2) Mildly dilated CBD with stent in situ & mild focal wall thickening at lower part
3) Normal size pancreas with heterogeneous texture.
4) Few mildly enlarged retro peritoneal lymph nodes.
5) Chronic cervicitis with PID.
Diagnostic approach:
7th October 2021
Cytology study indicated- Benign Ductal Epithelial Cells. Negative for malignancy
CNS :
(Captured by 2016 batch intern post final year mbbs) :
Problem list
GIDDINESS UNDER EVALUATION SECONDARY TO ? HYPERTENSION? WITH U/L OPTIC DISC EDEMA WITH PYEREXIA UNDER EVALUATION WITH K/C/O HYPERTENSION.
Diagnostic approach
Treatment:
INJ. MANNITOL 100ml IV/ TID
INJ. ZOFER 4MG IV/ BD
INJ. OPTINEURON 1AMP IN 100ML NS IV/ OD
INJ. CIGXANE 60MG SC/OD
INJ. NEOMOL 100ML IV/ SOS
TAB. VERTIN 16 MG PO/ BD
TAB. PCM 650 MG PO/ TID
Strict temperature monitoring 4th hourly
Strict BP monitoring 2nd hourly
(Captured by 2017 batch student final year MBBS):
(Captured by 2016 batch intern post final year mbbs) :
38 year old male who works as a real estate agent came to the opd with chief compliants of giddiness and blurring of vision since 4 days.
Pulmonology, Cardiology :
Problem list:
CKD ON MHD WITH HTN WITH B/L TRANSUDATIVE PLUERAL EFFUSION SECONDARY TO HD
Treatments
Salt and water restriction
Inj.augmentin 625mg od
Tab nicardia10mg tid
Tab.pantop 40mg od
Tab.lasix 40mg bd
Tab.orofer xt od
Tab shelcal.hs od
Tab nodosis 550mg od
Tab zofer 4mg tid
Nebulisation with budecort and salbutomol 8th hrly
Bp/pr/temp/spo2 and I/O charting monitoring
Nephrology :
(Captured by 2018 batch student final year MBBS):
Patient first came 14 days back with a complaint of pedal edema, pitting type, since 3 years. At first it was intermittent and aggregated on standing and when working and then since the past one month it has become continuous and unbearable
Not associated with pain, pruritus
3 years ago he was diagnosed with hypertension for which he is taking medication and from then he says he has developed pedal edema.
Q4) Testing competency in patient data capture and representation through ethical case reporting/case presentation with informed consent :
Share the link to your own case report this month 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.
ANSWER
https://04kavyasreekaluvala.blogspot.com/2021/09/general-medicine-blog-august-31-2021.html
Q 5) Testing scholarship competency in
logging reflective observations on your concrete experiences of this last month : (10 marks)
Reflective logging of one's own experiences is a vital tool toward competency development in medical education and research.
Our postings are going very well and everyday we are learning so many things in our clinical lecture halls . Because Biswas sir explain the case very clearly and questioning about the cases which really imparts us to learn .
As of I' am a 3rd sem student I am it the stage of history taking and I'am pretty Successful but I have confidence that I will be successful as days goes on in my practice.
Recently I had a case of Diabetic keto acidosis for which have seen the patient really for the first time and asked for the history. He was in ICU.
It was a great expierence in coming to hospital and taking history ,trying to understand, making blog on it .
our Interns and PG 's are really helping us in understanding various cases..
Comments
Post a Comment