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CLINICAL MEDICINE FORMATIVE ASSESSMENT (July)

SOUMYADEEP BISWAS 

ROLL NO. 127

I have been given the following cases to analyse and solve, in an attempt to understand the topic of  'Patient clinical data analysis' to develop my competency in reading and to comprehending clinical data including history, clinical findings, investigations and diagnosis, and then come up with a treatment plan.


Below are my answers to the medicine assignment based on my comprehension of cases.



ASSIGNMENT 

Ans.1 The link is attached for the peer review assessment https://rsubhiksha128.blogspot.com/2021/07/128-subhikshar.html

1. The review is done very well. It’s concise and to the point. She has brought up each and every said points about the same and highlighted the negative as well as the positive aspect of each case.

2. Her e-log is well written giving us a clear picture about the case , history , past illness , history of present illness and the treatment methodology that was taken up and the differential diagnosis.

3. She has highlighted the negative as well as the positive points regarding case and it’s well documented.

4. She has provided with a good diagnosis and the correct reason behind the treatment plan that is given making it a clear read for the students.


Ans.3 1. AKI - A good history has been taken with complete explaination of all the tests and the biochemical investigation done. 

2. Acute on CKD - all the examination and test have been documented well with a probable diagnosis 

3. CKD - the history has been taken well in a detailed manner and all the x ray are documented and histological slides are presented. Treatment was on point and a probable diagnosis is given.

4. Coma and renal failure - detailed report of all the procedure done including intubation , CPR. 2D echo video also included and mri with picture of sepsis along with treatment and diagnosis is also given.

5. Chief complaint is clearly written along with examination and vitals. Investigation reports are also given. Diagnosis was also given.

6. Proper ultrasound picture and treatment is given with a diagnosis.

7. Detailed history has been taken with all the examinations done. 

8. History was detailed and clearly stated. All the reports and examination were done. A diagnosis was also done.

9. History was concise and all other investigation has been documented along with a diagnosis.

Ans.4 1. Complaints: abdominal pain 
Burning micturition 
Oliguria 
Pedal edema , face puffiness 

Diagnostic and therapeutic intervention: blood urea was high indication problem related to kidney. AKI was diagnosed which would result in building up of waste product and makes kidney harder to remove it. 
Salt restriction so load on kidney is reduced , thiamine for new cell growth. Tatar acts an antibacterial.

2. Chief complaint: lower backache 
Pedal edema 
Dribbling of urine 
Increased involuntary movement

Diagnostic and therapeutic intervention: blood urea , creatinine , Utica acid all are elevated leading to a kidney problem. Tatar as an antibacterial , lasik to remove extra water as in urine ,Pantop along with Salbutamol is also given.

3. Chief complaint - mass per anal bleeding leading to haemorrhoids.
Muscle aches
Vomiting 
Pallor 

Diagnostic and therapeutic intervention: creatinine , urea and Uric acid are elevated probable damage to kidney. Chronic interstitial nephritis secondary to plasma cell days arias is because M band seen in the serum protein electrophoresis 

4. Chief complaint: fever 
Diarrhoea (blood discharge) 
Back pain 

Diagnostic and therapeutic intervention: bed sores developed thus antibiotics were given. Vegetative state. NORAD inj given to treat the hypotension. Dopamine inj act as inotropin for the better working of heart and increased blood flow to kidney. Noradrenaline is also given. Piptaz is used to treat pneumonia and infection caused by bacteria. 

5. Chief complaint: abdominal distension along with non healing injury may be due to diabetes mellitus. 
Pedal edema 

Diagnostic and therapeutic intervention: Klebsiella species is seen in culture with high urea levels. Bilirubin ans direct bilirubin all are increased. Hb is decreased. 
He is on blood thinners like ecospirin along with miniver that treat bacterial infection . Vancomycin is used to treat colitis (inflammation of intestine). Thiamine is used for cell growth. 
Atorvas is given to reduce heart attacks.

Ans.5 In the midst of the pandemic medical school taking the online approach which is primarily a practical sector. This is the educational set up where doctors interact with the patients and try to gather history and knowledge and try to provide their expertise. But still our medical schools are working and they have brought the clinical rotation for which we had always as a medical student being excited about right in front of our mobile/laptop screens. The general medicine faculty have been doing great and also are helping us to acquire knowledge and helped us learn to use the Internet and motivate us to read research papers and old cases about a topic. This has been a great learning session for all of us , looking forward to attend the clinical postings in the hospital.



































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