GENERAL MEDICINE BIMONTHLY ASSIGNMENT-JULY 2021

GENERAL MEDICINE

DIVYA POLAGONI

01(OLD BATCH 3RD SEMESTER)

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:

http://medicinedepartment.blogspot.com/2021/07/medicine-paper-for-july-2021-bimonthly.html?m=1

Below are my answers to the General Medicine Bimonthly Assignment based on my comprehension of the cases

QUESTION 1: 

Below is the link of the student assignment for which I am sharing my peer to peer review:

Case:https://04kavyasreekaluvala.blogspot.com/

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

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

*A detailed pinpoint review has been given to each particular case selected, which is helpful in easy analysis.

*Regarding the review she made it very clear by adding pictures wherever necessary.

*She gave picturisation, prime importance and included pictures wherever needed.

*The case details and the links were also mentioned.

*Every investigation and detailed history has been correctly described in order.

*Her idea of pictorial represented is easy to memorize and helps the visual learners.

*She gave the answers in her own kind of explanations.

*The points which were missing she made it very clear.

*The diagnostic and therapeutic intervention is one of the important aspects which is very well described.

*It would be much better if she could elaborate and explain more.

*Overall she did it very well and the explanation was good👌

*The e-log itself shows her great efforts and everything is done perfectly✅

QUESTION 2:

This is the e-log link which I made this month.

Below is the link👇

CASE LINK:

https://divyapolagoni01.blogspot.com/2021/07/divya-polagoni-01old-batch.html

QUESTION 3:

Testing peer review competency of the examinees:

Case 1:-

AKI :


My reviews on here e-log is as follows:

*Regarding the review she made it very clear by explaining everything in detail.
*Examination and investigations of the person are done and placed according to date.

Case 2:-

Acute on CKD :


My reviews on here e-log is as follows:
 
*This is a case of chronic kidney disease.
*She made the e-log very clear and explanation was good.
*The e-log can also be explained or mentioned much more better.

CASE-3:-

CKD :


My reviews on here e-log is as follows:

*Regarding the review she made it very clear by including LFT.
*2D echo,bone marrow aspiration test is also done to identify the disease.
*The case details are mentioned very clearly and the investigation is perfect.

CASE-4:-

Patient with coma and renal failure  :


My reviews on here e-log is as follows:

*Regarding the e-log she done the perfect e-log by adding the pictures of person.
*The investigation and the examination was very clear.

CASE-5:-


My reviews on here e-log is as follows:-

*Regarding the e-log she done with the great efforts.
*The videos and the picture will make us easy to memorize she done the great job by adding them.
*Investigation and examination is very clear.

CASE-6:-

Patients with acute on CKD :


My reviews on here e-log is as follows:-

*The explanation of e-log is good and the investigation is perfect.
*The case reports and the x-rays are shared very well.
*The picture of urine bag explain in a easy way.

CASE-7:-

Patients with acute on CKD :


My reviews on here e-log is as follows:-

*Investigation nd examination was explained very well.
*The presentation of e-log was good.

CASE-8:-

My reviews on here e-log is as follows:-

*The reports and pictures of the person explained well.
*The investigation and examination was very clear.

CASE-9:-

Patients with AKI :


My reviews on here e-log is as follows:-

*Regarding the e-log she done the great job by explaining clearly.
*The x-rays and pictures are very clear.
* The investigation and examination was explained very well.

CASE:10:-


My reviews on this e-log is as follows:-

*Regarding the e-log the explanation was good.
*Investigation was very clearly explained the reports explains everything.
*The presenter has to mention the name but in this case the details are not mentioned by his/her.

CASE-11:-

Patients with AKI :


My reviews on here e-log is as follow:-

*Regarding the e-log the case reports and pictures are clearly mentioned.
*Investigation is explained very clearly.
*The presentation of e-log itself shows the great efforts.

QUESTION 4:

CASE 1:-

AKI :


Complaints:-

. Patient had sudden onset of pain in abdomen.
. Decrease urine output associated with SOB(grade-4)

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  IN100ml NS IV/TID

6)INJ -HAI S/C ACC TO SLIDING SCALE 

8AM  -  2PM  -  8PM

7)SYP LACTULOSE 15ml  PO/TID [ To maintain stools less than or equal to 2]

8) GRBS  - 6th Hourly

9) BP/PR/TEMP - 4th Hourly

10) I/O - CHARTING

CASE 2:-

Diagnosis : Hyperuricemia 2°to renal failure

TREATMENT:
.IVF-NS-0.9%@100ml/hr
.Inj-Tazar 2.25gm I.V-TID
.Inj-Pantop 40mg I.V -OD 
.Tab-PCM 650mg -TID 
.Foleys catheterization 
.Temperature,Bp,PR Charting  hourly 
.Strict IO Charting
.GRBS -12th hourly 
.Inj-25% D with 10units of insulin IV -slow for 1hr

CASE 3:-

CKD :


Complaints:-

.Fever
.Generalized weakness
.Muscle aches and is taking NSAIDs


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  :


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:-

DIAGNOSIS:INFECTIVE 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

DIAGNOSIS:Renal AKI secondary to urosepsis with b/L hydroureteronephrosis

TREATMENT:
. INJ-PANTOP 40 mg iv/TID
. INJ-PIPTAZ 4.5 stat and 2.25 gm IV/TID
.INJ-LASIX 40 mg IV/TID
.INJ- optineuron 1AMP in 100 ml NS slow IV/OD

CASE 7:-

Patient with acute on CKD:

https://rishikakolotimedlog.blogspot.com/2021/07/45-year-old-male-with-chief-complains.html?m=1

DIAGNOSIS: HFrEF secondary to CAD;CRF

TREATMENT:
1.Tab-Bisoprolol 5 mg OD
2.Tab-Nitrohart 20/37.5mg 1/2 T/D
3.Tab-Nicardia XL 30 mg OD
4.Tab-Gliciazide 80 mg BD
5.TAb-Nodosis 500 mg TD

CASE 8:-

Patients with 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.
4.pantop
5.oxygen inhalation

CASE 9:-


COMPLAINTS:

.Loose stools since 20 days
.Pedal edema 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

     

CASE 10:-


DIAGNOSIS: Acute Kidney Injury secondary to Urosepsis

TREATMENT:
.Inj-LASIX 40mg (8am- 2pm -8pm)
.IVF-NS @ UO + 50 ml/hr

CASE 11:-

Patient with AKI


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 2 months, I have experienced and seen many cases. I have learned many things during the clinical postings.The General Medicine department are making us understand the subject by theory classes, postings (online) and making us to make elogs by this we are experiencing the case it was quite helpful for me.For every clinical case they have guided us how to study and analyze the case.I have learned how to capture the patient data for diagnosis of disease.It gives us an understanding on history taking and how to understand the investigations and come to a conclusive diagnosis.We have also learnt to respect the privacy of patient and that we should never expose the patient information.Personal history and family history is important for giving the right treatment with having any side effects to the patient.I hereby look forward to learn more about this and provide the right diagnosis and treatment to the patient.

THANK YOU FOR GIVING ME THE OPPORTUNITY
DIVYA POLAGONI 

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