BIOMONTHLY BLENDED ASSIGNMENT - JUNE 2021

NAME ; NANDINI GANDLA 

Roll No;38

Batch ;2019(3rd Sem)

QUESTION 1;https://generalmedicinedepartment.blogspot.com/2021/06/bimonthly-formative-and-summative_19.html?m=1

1.NEUROLOGY

CASE ;https://143vibhahegde.blogspot.com/2021/05/wernickes-encephalopathy.html

REVIEW ;https://blendedasessmentmadhukumar.blogspot.com/

This is a case of wernicks encepthalopathy secondary to alochol dependence and uraemic encepthalopathy and alchohol withdrawl delirium.Examination of all systems and required investigations are done .he had history of seizures in last year. and also known case of diabetes mellitus for 2 years.Patient also had tremors ,sleep disturbances, sweating.he also had a ucler on his right foot.The etiology for the patients condition is well explained in his case.wernikes encepthalopathy occurs due to thiamine defeciency for which he has administered with thiamine,his seizures are treated with lorazepam and his ulcer is dressed daily and megaheal ointment is applied.The patient was examined thoroughly and adequate investigations were done.The  case is well handled.

2.CARDIOLOGY

CASE ; https://muskaangoyal.blogspot.com/2021/05/a-78year-old-male-with-shortness-of.html

REVIEW ;https://csravanthi.blogspot.com/

A 78 year old male patient came to opd with shortness of breath,chest pain, bilateral pedal edema and facial puffiness .He is a chronic smoker and alcholic.He is known patient of diabetes mellitus and HTN .All investigations were made and 2D echo was normal with mild  pericardial effusion .ECG was taken and blood investigations were also done.Patient is hypotensive for which he is treated with nor adrenaline but there is no improvement.here they didnt do the pleural tap as they predicted beforehand that there may be risk of lung injury which is very good..This is a case of Acute pericarditis with    moderate pericardial effusion.At the time of discharge necessary medications were given .And all symptoms of patient was treated and the case was handled very good and his symptoms were subsided.

3.GASTRO ENTEROLOGY

CASE ;https://63konakanchihyndavi.blogspot.com/2021/05/case-discussion-on-pancreatitis-with.html

REVIEW ;https://akash688.blogspot.com/

This is a case of pancreatitis , pseudocyst and left broncho pleural fistula.The patient  presented with pain abdomen and vomiting and constipation,burning mituration.he is a chronic alchoholic.He has no histroy of HTN and diabetes mellitus.All investgations and examinations were done .this case is well presented with all necessary details and all reports of the patients were attached which will give us about the clear idea about the case .the patient is treated well for all his symptoms. He was treated with MEROPENEM for his infection and PANTOP Injection  to inhibit gastric secretion. The reasons for all his complaints  were explained and medication is given accordingly. 

4 . NEPHROLOGY AND UROLOGY: 

CASE:https://kavyasamudrala.blogspot.com/2021/05/medicine-case-discussion-this-is-online.html

REVIEW:https://jatinsharma46.blogspot.com/

This is a case of renal AKI secondary to bilateral hydroureteronephritis with known history of diabetes mellitus since 5 years with diabetic neuropathy with anaemia secondary to CKD with  grade 1 bed sore. The chief complaints of the patient  are pus in urine and fever. The patient has SOB due to acidosis that is caused by diuretics. May be his hyponatremia was the cause of his drowsiness and plenty of pus  is  seen in urine and difficulty in Mictutration and he had raised creatinine levels also. All necessary investigations and good analysis is made. The patient is treated very well to relieve his from all his symptoms . 

5 . INFECTIOUS DISEASE AND HEPATOLOGY :

CASE:https://kavyasamudrala.blogspot.com/2021/05/medicine-case-discussion-this-is-online.html

REVIEW :https://jatinsharma46.blogspot.com/

This is a case of acute viral hepatitis and liver abscess,acute cholecystitis, acute cholangtis . The chief complaint of the patient is abdominal pain and fever. The case is very well presented and highlighted many important things that are to be noted and should be taken care of  and also very well discussed about the etiology, pathogenesis, risk factors  of the disease in the review. Treatment given along with rationale is explained in an understandable way. They gave necessary medications for reduction of all his symptoms. 

6.PULMONOLOGY :

CASE:https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html

REVIEW:https://amishajaiswal03eloggm.blogspot.com/

This is a case of viral pneumonia secondary to COVID-19. The patient came to the OPD with chief complaints of SOB, cough, fever. Which was progressed from Grade -1  to Grade -3 . A HCRT report showed CORADS-4 and a severity of 3/25.His SOB and low SOP2 was treated with O 2 inhalation and necessary medication were given. He was monitored for 4 days and got discharged. 

7.NEUROLOGY :

CASE :https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html

REVIEW :https://rishikoundinya.blogspot.com/

This is a case of seizures. A 55 year old male patient came to the opd with chief complaints of altered sensorium and involuntary movements on further investigations . Inspired of his treatment he had recurrent episodes of seizures since 5 years. At the time of presentation he was  drowsy and was diagnosed with HTN. On CNS examination he had slurred speech and on motor examination, he had hypotonia in left upper limb and lower limb. He was treated with LORAZEPAM 2 CC injection given IV 3 times to treat his seizures. 

8.INFECTIOUS DISEASE (HI VIRUS, MYCOBACTERIA, GASTROENTEROLOGY, PULMONOLOGY) 

CASE:https://vyshnavikonak alla.blogspot.com/2021/05/a-40-year-old-lady-with-dysphagia-fever.html

REVIEW:https://87tharunkumar.blogspot.com/

This is a case of tracheoesophagal fistula and oral candidiasis or oesophagal strictures. The patient has chief complaints of difficulty in swallowing, cough on taking food and liquids and had  a weight loss. In the review the chance of patient developing immune reconstitution inflammatory syndrome is very well explained with the help of a flow chart. All examinations were done thoroughly and barium swallow is also done. In this case a very detailed review is not written.

9 : CARDIOLOGY :

CASE :https://daddalavineeshachowdary.blogspot.com/2021/05/67-year-old-patient-with-acute-coronary.html

REVIEW:https://nehae-logs.blogspot.com/

This is a case of acute coronary syndrome. The patient came to OPD with shortness of breath . She is known case of HTN and DM. The review is very well written in the form of nice flow chart about her past illness to present illness. And risk factors of DM and HTN point to a cardiac origin is also explained. In the review indications and contradictions of PCI is very well explained. The patient is treated for all her symptoms. 

10. NEUROLOGY :

CASE :https://nikhilasampathkumar.blogspot.com/2021/05/a-48-year-old-male-with-seizures-and.html?m=1

REVIEW :https://123sarbeshmishra.blogspot.com/

This is a case of generalized tonic - clinic seizures secondary to acute haemorrage in the frontal, temporal, pariteal, lobes with a 13 mm midline shift. The patient came with chief complaints of that he suddenly became drowsy and stopped response to verbal instructions. All the investigations were done thoroughly and the cause for which the patient got unconscious is very well explained and also about risk factors. All necessary medications were given to treat his symptoms. 

2 . QUESTION

I haven't got any chance to make a case report yet. 

3. QUESTION

ABDOMINAL :

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. The patient presented with chief complaints of pedal edema and decreased urine output. The patient was diagnosed already with actue kidney injury secondary to urosepsis and it got resolved conservatively after dialysis. All investigations like complete urine examination, ECG, ultrasound is done, ABG analysis is also done. Bacterial and sensitivity report and complete blood picture is done. The case is very well presented and daily update on her blood picture is done. This was treated with injection LASIX 40 mg and IVF -NS @UO +5 ml/hr and other necessary investigations were given to relieve her symptoms and for good recovery. 

4 . CVS :

https://60shirisha.blogspot.com/2021/06/medicine-case-discussion_14.html?m=1

This is a case of HFrEF with atrial fibrillation. The patient had chief complaints of abdominal distension and SOB. She is a known case of hypothyroidism since 5 years and had no history of palpitations, pedal edema, oliguria. She was on THYRONORM 100 mg OD for hypothyroidism. Her troponin -1 is negative. The investigations done in this case are complete blood picture, serum electrolytes, HIV 1/2 rapid test, glycated hb, CRP blood sugar random and 2D echo is also done. By seeing biochemical report we can say that she is suffering from severe hyperthyroidism possibly relating to her atrial defibrillation and attempted for defibrillation but unfortunately she had passed away. 

QUESTION 5 :

In the last month we started to attend our clinical postings but the clinical postings were online and was it was quite challenging and a bit confused about the postings. We just learnt how to take history of the patient and how to approach patient and extract all the required data to treat patient condition. And also the importance how accurately we take history and how it is helpful for the diagnosis of the disease. I am still eagerly waiting for making my first e log. The experience is really awesome and due to the postings we actually realize what the actual role of a doctor but due to online sessions we are not enjoying it fully. Our rakesh biswas sir and intern sirs and mams trying their best to make us understand about the case and passing there knowledge to us. Although it is very nice experience we get from these clinical postings.