General Medicine October Assesment

 M.Sneha

Roll no -74

3rd Semester

QUESTION-1 :

Critical Appraisal -

GASTROENTEROLOGY -

https://63konakanchihyndavi.blogspot.com/2021/10/a-case-discussion-on-chronic-liver.html

- The case discussed is of Chronic liver failure and kidney disease.

- The case is very well explained.

- The main abnormalities of patient are highlighted which are easy to grasp. 

- There is a video link kept which is very clear about ascitic tap.

CNS -

 http://keelasreevalli.blogspot.com/2021/09/a-52-yr-old-female-homemaker-by.html

- This case is well presented.

- The day to day investigations and treatment are mentioned clearly.

- The clinical presentation of patient is clear in the pictures.

HAEMATOLOGY -

https://mahithguduri63.blogspot.com/2021/09/pancytopenia-under-evaluation.html?m=1

- The above case presentation is nice. 

- The case is of Pancytopenia. 

- The vitals of the patients are well updated day to day.

CARDIOLOGY , PULMONOLOGY -

https://vamsikrishna1996.blogspot.com/2020/12/supraja-medicine-elog-nephrology-case.html?m=1

- The case is explained good.

- It would be more effective if the main events are highlighted.

- The 2 D Echo video of the patient is presented so the cardiovascular activity is better understood.

NEPHROLOGY -

https://bhargavikantipudirollno21.blogspot.com/2021/10/a-46-year-old-male-with-pedal-edema.html?m=1

- The case presentation is nice.

- As the case is currently ongoing the investigations and treatment are to be updated.


QUESTION- 2 , 3 :

DIAGNOSTIC AND THERAPEUTIC INTERVENTION -

GASTROENTEROLOGY -

https://63konakanchihyndavi.blogspot.com/2021/10/a-case-discussion-on-chronic-liver.html

Diagnosis : 

Chronic liver failure and kidney disease.

Investigations :

- RFT , LFT 

- HEMOGRAM , CUE 

- ECG , USG 

- Abdomen , BGT , ABG 

- VIRAL SEROLOGY , CHEST X RAY, 2D echo.

Treatment :  

- Fluid restriction : < 1t / day

- Salt restriction : < 2gm / day

- Tab . Lasix - 40 mg , BD

- Tab . Metalazone 5mg , BD 

- Tab . Thiamine 100 mg , OD

- Syrup . Lactulose 15 ml , BD

- Tab . Rifagut 550 mg , BD

- Protein powder with 100 ml milk , 2 times daily 

- Abdominal girth & weight measurement daily

- Tab . Udiliv 300 mg , BD

- 2-3 egg whites / day

CNS -

http://keelasreevalli.blogspot.com/2021/09/a-52-yr-old-female-homemaker-by.html

Diagnosis :

Altered sensorium under evaluation secondary to hyponatremia( euvolemia)?SIADH 

Sepsis secondary to ?cellulitis ? Typhoid

with complete right bundle branch block.

Investigations :

- CBP , CUE 

- LFT , RFT 

- Serum osmolarity , Serum Electrolytes 

- ECG , Urinary electrolytes 

- MRI brain , Chest X Ray

Treatment :

- Propped up position 

- IVF 3% Nacl @10 ml/hr 

- Ryles catheterization 

- Foley's catheterization 

- Inj.Piptaz 4.5 gm /IV/BD

- RT feeds : 100ml water 2nd HRLY 

                        50 ml milk 4rth HRLY 

HAEMATOLOGY -

https://mahithguduri63.blogspot.com/2021/09/pancytopenia-under-evaluation.html?m=1

Diagnosis :

Pancytopenia under evaluation

Investigations :

- Haemogram, LFT 

- Blood grouping and Rh typing 

- Serum Electrolytes ,Blood Urea 

- T3,T4,TSH, Bone marrow biopsy, ECG 

Treatment :

- Inj METHYLCOBALAMINE 1000mg IV OD

- Inj IRON SUCROSE 1 amp in 100ml NS IV

- Vitals monitoring

CARDIOLOGY , PULMONOLOGY -

https://vamsikrishna1996.blogspot.com/2020/12/supraja-medicine-elog-nephrology-case.html?m=1

Diagnosis :

CKD ON MHD WITH HTN WITH B/L TRANSUDATIVE PLUERAL EFFUSION SECONDARY TO HD

Investigations :

- Prothrombin time , LFT

- ABG, CBP, ECG

- Chest X RAY , 2D Echo

- Haemogram, Lipid profile

Treatment :

- 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 -

https://bhargavikantipudirollno21.blogspot.com/2021/10/a-46-year-old-male-with-pedal-edema.html?m=1

Investigations :

- Hemogram

- RFT, CUE 


QUESTION - 4 :

https://madamsneha74.blogspot.com/2021/09/gen-medicine-case-study.html

QUESTION - 5 :

Changing to Competency based medical education is very helpful as it gives us as medical students a basic idea to know about the clinical scenarios even from the 1st professional year which include the case presentation in the form of question and answers posed by our faculty. This is very useful in this modern era to build a efficient and skilled doctor who forms a healthy society.








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