Skip to main content

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.



































Comments

Popular posts from this blog

CLINICAL MEDICINE FORMATIVE ASSESSMENT

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. This is the link of the question asked regarding the case  https://medicinedepartment.blogspot.com/2021/06/medicine-department-paper-for-june-2021.html?m=1 Below are my answers to the medicine assignment based on my comprehension of cases. ASSIGNMENT Ans.1 PULMONOLOGY - the patient came with the chief complaint of shortness of breath , pedal edema and puffiness in face. It is a case of COPD and right heat failure. The patient also has bronchiectasis which permanently dilates the bronchi leading to increased mucous formation and difficulty in breathing. Her puffiness in face and pedal edema is due to the increased hydrostatic pressur...

A CASE of 48 yr old male with fever , paraperisis and altered sensorium

E-LOGS MEDICINE Hi , I am Soumyadeep Biswas a medical student. This is an E-Log that would help us to understand the patient centered approach for learning medicine. This E-Log has been created after taking consent from the patient and their relatives. Hope you gain some knowledge after going through the case. July 2 , 2021 48 YR OLD MALE PATIENT DIAGNOSED WITH ALTERED SENSORIUM SECONDARY TO MENINGOENCEPHALITIS CHIEF COMPLAINTS Fever since 10 days Altered sensorium  since 5 days Weakness of bilateral lower limbs - 3days  H/O of Oliguria since 3days HISTORY OF PRESENT ILLNESS  Patient was apparently  asymptomatic 1yr back , then he developed decreased urine output for which they admitted in hospital and Foley’s Catheter was placed , then he was diagnosed with  Prostatomegaly  with Rt renal calculi.  Since 10 days patient has high grade fever on and off  not associated with vomiting/loose stools/cough. Altered sensorium since 5 days. Si...

OSCE

OSCE DISCUSSION OSCE CASE LINK:  https://127soumyadeepbiswas.blogspot.com/2023/12/a-65-year-old-male-with-dka-with.html OSCE question and answers 1. What is diabetic ketoacidosis (DKA) ? Ans. Diabetic ketoacidosis (DKA) is an acute, major, life-threatening complication of diabetes characterized by hyperglycemia, ketoacidosis, and ketonuria. It occurs when absolute or relative insulin deficiency inhibits the ability of glucose to enter cells for utilization as metabolic fuel, the result being that the liver rapidly breaks down fat into ketones to employ as a fuel source. The overproduction of ketones ensues, causing them to accumulate in the blood and urine and turn the blood acidic. DKA occurs mainly in patients with type 1 diabetes, but it is not uncommon in some patients with type 2 diabetes. Laboratory studies for DKA include glucose blood tests, serum electrolyte determinations, blood urea nitrogen (BUN) evaluation, and arterial blood gas (ABG) measurements. Treatment includes ...