SHRUTHI ARUKONDA 02

           GENERAL MEDICINE ASSIGNMENT 

                         Shruthi Arukonda 02  (3rd sem) 

                        Monthly  online assignment

 

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:


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


QUESTION ONE: 

1. PULMONOLOGY CASE: 

          
  • Evolution of symptomatology has been very well explained with a proper timeline for clear understanding. 
  • The mechanism of action has also been depicted well 



2.NEUROLOGY CASE:A


  • The pathophysiology has been excellently explained with proper illustrations. 
  • The reason for giving the patient has been highlighted well giving proper reasons. 



3.NEUROLOGY CASE:B


  • The anatomical location of the infarct and the ethology has been clearly demarcated. 
  • Mode of administration and the indications has been described for each and every drug which is very beneficial 



4.CARDIOLOGY CASE: 


  • Well explained with the help of pictorial depictions 
  • The risk factors for development oh heart failure are explicit. 



5.GASTROENTEROLOGY CASE:A


  • The symptomatology is explained properly with a proper timeline. 
  • The non pharmacological treatment modalities have been researched well 



6.GASTROENTEROLOGY CASE:B 


  • The relation of pleural effusion to pancreatitis has not been explained 
  • The treatment plan given is good. 



7. INFECTIOUS DISEASE : 


  • A better clinical history and physical findings could be given. 
  • Flow charts presented are good for understanding 



8. NEPHROLOGY AND UROLOGY: 


The answers were very brief. Easy to understand but could be explained further for a proper idea. 




9. NEPHROLOGY AND UROLOGY :B 


The management of the disease and the drugs have been well explained. 





QUESTION TWO:
Elog of a patient, related case discussion.  

I have made an Elog on a 21 year old female which chief complaints of left shoulder joint pain and pain of the right TMJ.  




QUESTION THREE & FOUR: 

This is a case of acute kidney injury on chronic kidney disease (hypertensive nephropathy) with uraemic encephalopathy. The patient has presented with altered sensorium and has been lethargic. Followed by pedal edema with anasarca with shortness of breath even at rest. The patient has been asymptotic until 5 years back. 
At the time which he complained of back pain and neck pain and the creatinine levels have been high. And had been given medications which he failed to take systematically. There is no history of decreased urine output, no history of fluid loss or drug intake.  Although, he is a known case of hypertension and also a known case of chronic diseases since past 5 years. For both of which he has been taking medications. On general general examination he is found to be drowsy but arousable. And pallor is present. Rest everything appears to be normal. Vitals are normal. Dyspnea is present. Free fluid of abdomen(ascites) is seen. All the reflexes are intact.
Hemodialysis has been advised.  
For further knowledge of the hypertensive nephropathy with uraemic encephalopathy the follows articles should be referred.  




Diagnostic and therapeutic intervention. : 

ECG-report must be taken to check any left ventricular hypertrophy 
CBC- detect leucocytosis which may suggest an infectious cause abs determine weather anemia is present. 
Urine analysis.- microalbuminuria. 
Ultrasound- to check the kidney size whether it’s symmetric or normal or moderately reduced. 
Order a toxicology screen. 

Treatment : 

IVF-NS(0.0+30ml/hr)
INJ.LASIX(40mg/IV/TID)
INJ.NaHCO3(100meq in 100ml NS/IV/Stat)
T.NODOSIS 550mg/P.O/TID Post: Edit
BP/PR/Strict I/O Charting





QUESTION FIVE:
 

There is no doubt that pandemic has been really tough on all of us. It has put a sudden jolt on all our academic routines and day to day life. And the medical students have had the greatest impact. As the students of the third semester, we were all excited to attend our clinical postings as it is the foundation of our medical careers and the knowledge it offers is of great importance to shape us be better doctors. To be not able to attend our clinical postings physically has been really challenging as nothing triumphs a patient-doctor interaction in person. But, over the course of last month Dr.Rakesh Biswas, the HOD of general medicine and the entire department has been really helpful to us and have done the best in their being for us to get a maximum exposure out of this.  We have learnt the basics of how to take down history and write case sheets and also how efficiently E-blogs can be used to to put down what we have learnt in a proper performa. Though the experience has been really thrilling we look forward to attend the clinical postings in person and get the at most knowledgable experience out of this. 










































































































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