BIMONTHLY BLENDED ASSIGNMENT
G. NANDINI
ROLL NO : 38
3 RD SEM
I HAVE BEEN GIVEN THE ASSIGNMENT TO CHECK OUR ABILITY TO CONNECT WITH AND CAPTURE PATIENT CENTERED DATA AND ALSO THE ABILITY TO CONNECT WITH AND ENGAGE IN SHARED LEARNING WITH THEIR PEERS THROUGH PEER REVIEW FEEDBACK.
This is peer review of last assignment of G. Jagadeesh . (Roll no:37)
QUESTION 1:http://medicinedepartment.blogspot.com/2021/07/2019-batch-medicine-department-online.html?m=1
REVIEW :https://gouthajagadeesh37.blogspot.com/
Q1:He took all 10 different cases and He explained each case very well and the important thing is he also mentioned the residence of the person in the review of the case which he has written. which is very important and also explained very well about the symptoms of the patient and cause of those symptoms and how the treatment is given accordingly and also how the drugs act to reduce the symptoms. He also highlighted the important points with bold letters so that it is useful to read the entire case very fast in case of emergency. He also attached all the investigations done in each case and pictures of the patients. All provisional diagnosis and treatment part is also written.
Q2: He didn't do any e log
Q3 and Q4: He explained a case on cvs in which all chief complaints of the patient mentioned briefly and he didn't elaborated about systemic and general examination part well and but reports of all investigations done are attached as the part of case and treatment part is also not explained very well but the overall if we read the review we can understand the case and I think the review is not too good or too bad.
Q5: This question is very genuinely answered by him. He explained what problem he is facing with online classes.
QUESTION : 2
I haven't done any e log yet .
QUESTION : 3 AND 4
CASE link:https://laharikantoju.blogspot.com/2021/07/58-year-old-male-patient-elog-lahari.html?m=1
CRITICAL APPRAISAL AND IN SIGHTS ABOUT CASE:
This is case of acute kidney injury with lower back ache. The e log is made in such a way that there is no confusion in any headings all were very clear with every thing written in a chronological order and the daily update on which date which investigations done and the results of all tests kept very clearly. The treatment part is also written in a elobarated way and in that what the patient should not eat is also written. And the timings when they gave the drug is also mentioned which is very important. All the reports attached was not so clear.
A 58 year old male patient came to casualty with chief complaints of:
- lower abdominal pain: 1 week
-burning micturation:1week
- low back ache after lifting weights
-dribbling / decrease of urine out put:1week
-fever :1 week
- SOB , rest :1week
1. COMPLAINTS AND DURATION:
-week back , after weight lifting
Patient had sudden onset of pain in abdomen
By burning micturation with high fever : grade associated with chills and rigor
Decrease urine output associated with SOB (grade -4)
INVESTIGATIONS ORDERED :
Hemogram , CUE , RFT , LFT , ECG , 2D Echo , Chest X-ray , FBS , PLBS ,HbA1C
* PROVISIONAL DIAGNOSIS :
-Acute kidney injury( AKI) 2° to UTI, associated with Denovo - DM -2
-With ? Right HEART FAILURE,
-With K/C/O - HTN ( Not on Rx)
- AKI causes a build-up of waste products in your blood and makes it hard for your kidneys to keep the right balance of fluid in your body.
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 IN 100ml 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]
CASE :http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html
CRITICAL APPRAISAL AND IN SIGHTS ABOUT CASE:
This is a case of chronic kidney disease.This e log is very good and the present illness if the patient is explained very well with all his symptoms . All the investigations and examination were done and the reports of the investigations we very clear . The treatment done is updated every day which is very nice in this log and complete data is provided in the log and also given details to make a good provisional diagnosis.
A 75yr old male patient ,labourer by occupation ,came to casuality with Cheif complaints of
• Lower backache since 10days
• dribbling of urine since 10days
• Pedal edema since 3days
• SOB at rest since 3days
• Increased involuntary movements of both upper limbs since 10days .
Probable Diagnosis
CASE 3:https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1
This is a case of chronic kidney disease. The chief complaints of the patients are written but it's written like both present and past history of the patient together . The personal history and Obsertic history is well elaborated . All examinations and investigations were done with all reports attached. The very good thing in this log is the reports of investigations done in other hospital were also attached here . Which is very useful for doctor.
*A 49 yr old female , mother of 2 children, who is a , apparently asymptomatic 13 yrs ago and then she noticed mass per anum with bleeding , went to hospital and diagnosed as haemorrhoids and got operated.
- Since 3 yrs she has history of muscle aches, for which she is using NSAIDs.
- She has h/o fever 20 days back, got treated in the local hospital, and
- Since 20 days she has generalized weakness.
- She also has h/o vomitings since 3 days, with food as content, non - projectile , non bilious.
- Urine output - Normal
- No fatigability , pedal oedema ,
- No SOB , facial fluffiness , yellowish discoloration of stools
- Fever and Diarrhea since 5 days( 4 to 5 times a day with blood discharge).
- Back pain( 5 days ago) with abdominal pain and chest pain.
- Provisional diagnosis: DKA with AKI ( ? Pre renal)
Treatment:
Inj. NORAD 2amp in 50ml NS
Inj. PIPTAZ 2.25gm.
Inj. DOPAMINE 2amp in 50ml
Inj. HAI 1ml in 39ml NS
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
This is a case of chronic kidney disease. The chief complaints of the patient is highlighted in the first line briefly which is very nice and all pictures are attached in the log but the treatment history is not updated. I think the same treatment history may be repeated and investigations with dates are kept and very well provisional diagnosis made . She highlighted the important things and which is very much useful.
A 52 yr old male patient who is a farmer by occupation
Presented to hospital on 14 June 2021 with Chief Complaints of
Fever since 4 days
Pus in the Urine
Diagnosis
Renal AKI secondary to urosepsis with b/L hydroureteronephrosis with K/c/of DM -2 since 5 yrs with diabetic nephropathy with Anemia secondary to CKD with grade 1 bed sore
TREATMENT
CASE 7:https://rishikakolotimedlog.blogspot.com/2021/07/45-year-old-male-with-chief-complains.html?m=1
This e log very nicely made and the headings are highlighted so there is no clumsy feeling the log is very clear and she also wrote about pre and post medication findings. This also attached how the disease will cause and preventive measures to take to avoid the cases . All reports were arranged orderly and which are very clear.
CHIEF COMPLAINT - 48-Year-old male presented to the OPD with chief complaints of Shortness of Breath grade -II from the past 1 week, which converted into grade -III-IV from the past 4 days
PROVISIONAL DIAGNOSIS - HFrEF secondary to CAD; CRF
1. TAB. BISOPROLOL 5mg OD
2.TAB. NITROHART 20/37.5mg 1/2 T/D
3.TAB NICARDIA XL 30mg OD
4.TAB. GLICIAZIDE 80mg BD
5.TAB. NODOSIS 500 mg TD
6.Cap. BIO-D3 OD
7.Cap. GEMSOLINE OD
8.TAB. ECOSPRIN-AV 150/20mg OD
9.TAB.LASIX 40mg BD
10. SYP. LACTULOSE 15ml
CASE 8:
https://krupalatha54.blogspot.
This case is explained well but I think the case is not explained in chronological order and it is bit clumsy I think the log should be made some what clear. But all the investigations with reports attached well. The pictures of the patient are very good so that it will easy to understand about the patient. Discharge summary is also written which is very good. And treatment is also written Elobarately.
CASE 9:
https://keerthireddy42.blogspot.com/2021/07/43-yr-old-male-of-nalgonda-came-to.html?m=1
This is a case of alcoholic hepatitis with acute kidney disease secondary to gastroenteritis.In this case the chief complaints are written well. Every day vitals were also documented along with treatment history which is very important to know the rate of recovery of patient by seeing all this data . To show the icetrus and pedal edema the pictures of the patient are attached which is very good.
A 43 yr old male ,resident of nalgonda came to casuality with chief complaints of
- loose stools since 20 days
- Pedal edema since 20 days
- Abdominal distension since 20 days
PROVISIONAL DIAGNOSIS: ALCOHOLIC HEPATITIS ,
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:https://casescape.blogspot.com/2021/06/acute-kidney-injury-secondary-to.html?m=1
This is a case of acute kidney injury secondary to urosepsis. In this e log all the biochemical investigations done daily are written only in one place along with date . Which is very much useful. I think the patient pictures should have uploaded so that when we see the elog we can have a little idea how the patient is presented. Treatment history is also updated well.
A 60yr old female presented to the OPD with chief complaints of pedal edema since 10 days, decreased urine output since 10 days and fever since 10 days.
- Acute kidney injury secondary to urosepsis
- Treatment:
- Inj LASIX 40 mg IV/TID [ 1 -1 - 1 ]
- Tab Norflox 200 mg PO/BD
- Tab ULTRACET 1/2 tab QID[ 1/2 - 1/2 - 1/2 - 1/2 ]
- Tab OROFEA - XT PO/OD
- Tab SHELCAL-CT PO/OD
- Inj HAI s/c TID [ 10U - 8U - 8U ]
- BP/PR/SO2/Temperature monitoring
- GRBS charting
- Strict I/O charting
CASE 11:
http://chavvaclassworkdecjan.blogspot.com/2021/06/pancreatitis-in-chronic-alcoholic-with.html?m=1
This is a case of pancreatitis in a chronic alcoholic with acute kidney injury. The case is explained well with all investigations done and reports of them. The pictures of the patient also uploaded. At the last summary is written which is very useful thing in this e log.
31 yr male farmer by ocupation,resident of Miryalguda Came with cc of pain in abdomen since a weekVomiting since a week.Sob since 2 days.
T R E A T M E N T :
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