93 N. Lavanya

 General Medicine Assignment 2 

  

93 N. Lavanya ( 3 rd semister) 

Question 1: Competency tested for Peer to peer review and assessment : 

Please go through one student's entire answer paper from this link, the one who is closest to your own roll number 

https://nadipisneha.blogspot.com/

 Presentation is good , Suggestions given were appropriate about the pictorial presentation  , flow chart presentation etc 

                    It would have been good if the scoring was given  like 10/10 some thing like that Or staring it 

                               The good points were also well appreciated about the drugs efficacy or about treatments . 

Question 2

) Share the link to your own case report of a patient that you connected with and engaged while capturing his her sequential life events before and after the illness and clinical and investigational images along with your discussion of that case. 

https://1drv.ms/p/s!Amzw-w27ZqwrboyIC_IOcH8OYD8

Question 3 

Share the link to your own case report of a patient that you connected with and engaged while capturing his her sequential life events before and after the illness and clinical and investigational images along with your discussion of that case. 

                               

 

 1.http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html

Probable diagnosis is very well explained ,All the info is well incorporated 

                      Drug History and family history is not mentioned 

2.https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1

Excellent presentation , with lot of efforts have been put All the information is well incorporated   with detailed investigations and treatment 

3.https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html

Presentation  is very good with detailed examinations and investigations with well mentioned dated but diagnosis is not mentioned

4.https://pallavi191.blogspot.com/2021/06/gm-cases_30.html?m=1

Good presentation, the final diagnosis is well explained  in a detailed manner

              Well mentioning of dates and investigations 

5.https://kavyasamudrala.blogspot.com/2021/05/medicine-case-discussion-this-is-online.html?m=1

Detailed examination is done, with well mentioned dates and investigations

             Detailed examination on hydronephrosis

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

Detailed presentation, The investigations are well highlighted . Well mentioning of dates and investigations

7.https://krupalatha54.blogspot.com/2021/06/this-is-online-e-log-book-to-discuss.html?m=1

Neat presentation with detailed pictures and investigations and detailed History taking

8.https://keerthireddy42.blogspot.com/2021/07/43-yr-old-male-of-nalgonda-came-to.html?m=1

Detailed presentation with good pictures taking in care of privacy of the patient . 

9.https://casescape.blogspot.com/2021/06/acute-kidney-injury-secondary-to.html?m=1

Excellent presentation. Good efforts are made to put together all the levels of urea and creatinine with well mentioned dated 

10.http://chavvaclassworkdecjan.blogspot.com/2021/06/pancreatitis-in-chronic-alcoholic-with.html?m=1

Good presentation with well mentioned investigations and dates 

11.https://laharikantoju.blogspot.com/2021/07/58-year-old-male-patient-elog-lahari.html?m=1

The entire presentation is neat and clean , well prepared with proper dates, examinations  , and prognosis 

          Elog is made with all the necessary info 

              With detail explanation

Question 4

Please analyze the above linked patient data by first preparing a problem list for each patient (based on the shared data) and then discuss the diagnostic and therapeutic uncertainty around solving those problems. Also include the review of literature around sensitivity and specificity of the diagnostic interventions mentioned and same around efficacy of the therapeutic interventions mentioned for each patient. 

https://laharikantoju.blogspot.com/2021/07/58-year-old-male-patient-elog-lahari.html?m=1

Problems

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

blurring of vision, black outs

tenderness present(in supra public pain RIF)

Diagnosis 

Acute kidney injury( AKI)  2° to UTI, associated with Denovo - DM -2

With ? Right HEART FAILURE,

-With K/C/O - HTN

Interventions 

Hemogram , CUE , RFT , LFT , ECG , 2D Echo , Chest X-ray , FBS , PLBS ,HbA1C

.http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html

Problems 

Lower backache since 10days(which is insidious in onset & gradually progressive with dull aching type of pain radiating to right lower limb,which is slightly relieved on rest  and there is no diurnal variation.) 

• dribbling of urine since 10days

• Pedal edema since 3days 

• SOB at rest since 3days 

• Increased involuntary movements of both upper limbs since 10days . 

Weakness, tingling sensation and numbness of both upper and lower limbs since 3days .There is dragging type of pain ,severe and radiating to right lower limb.

Pedal edema which is insidious in onset & gradually progressive ,pitting type extending upto the knee .

Diagnosis

Acute renal failure (intrinsic)

 Grade 1 L4-L5 Spondylodiscitis ,Multifocal infectious Spondylodiscitis

Hyperuricemia 2° to Renal failure 

Uraemia induced tremors( resolved)

Delerium 2° to septic /Uremic encephalopathy (resolving)

Investigations 

ECG, RFT, CUE, Hemogram, ABG , Serum electrolytes, Blood urea ,USG Abdomen ,LF

.https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1

Problems

haemorrhoids and got operated.

history of muscle aches, for which she is using NSAIDs.

h/o fever 20 days back, got treated in the local hospital

vomitings since 3 days, with food as content, non - projectile , non bilious.

Tubectomy done  after  2 nd child birth.(25 yrs ago) 

Diagnosis

CKD   Chronic interstitial nephritis secondary to plasma cell dyscariasis, (multiple myeloma - 70% plasmacytosis).

Investigations

Complete blood picture 

 

Heamogram

ECG

Bone marrow aspiration

USG abdomen

2Decho

https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html

Problems  list

• 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.

Type 2 Diabetes 3 years ago and was put on some oral hypoglycemic agents 

Back pain had occured 1 year ago for which she took antibiotics

she complained of severe breathlessness and pain in the chest region.

GRBS(general random blood sugar)  was 580mg/dl for which 10 units of insulin was infused. 

Diagnosis

DKA with AKI ( ? Pre renal) 

USG(25/06/21) - Pyelonephritis. 

Investigations 

ABG analysis

Complete blood picture

Kidney function tests 

Liver function tests 

Haemogram

Bacteria culture and sensitivity test

https://pallavi191.blogspot.com/2021/06/gm-cases_30.html?m=

Problems list

 non healing injury to the right foot which raised a suspicion of Diabetes mellitus. 

 diagnosed with Diabetes mellitus type 2 and was started on Tab. GLIMI M2 OD. 

2 years back he complained of Tingling in the upper limbs up to the palms, in the lower limbs up to the knee. 

 From the past 7 Days, He Complains of Abdominal Distension.

From the past 5 days, he complains of Constipation and has not passed stools since 5 days.

He also complains of altered Sleep patterns from the past 5 Days 

pedal edema grade 2

Provisional Diagnosis:

Infective endocarditis?

Hepatic encephalopathy?

Investigations 

Liver function test 

Complete urine examination

Heamogram

Renal function test 

https://kavyasamudrala.blogspot.com/2021/05/medicine-case-discussion-this-is-online.html?m=1

Problems list

Fever since 4 days

 Pus in the Urine

type 2 diabetes and on treatment Tab GLIMI M1 and goes for regular check up.

year back, he gradually developed drippling of urine, Hesitation, reduced flow of urine, 

He had Prostomegaly(60gm) and advised TURP

Decreased appetite 

Generalised weakness

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 sorry

Treatment

Injection PANTOP 40mg IV/OD

Injection PIPTAZ  4.5 stat  and 2.25 gm  IV/ TID

Injection LASIX 40mg IV/BD

Injection optineuron 1AMP in 100ml NS slow IV/OD

Injection NEDMOL 100ml IV/SOS

Tab PCM 650mg TID

Insulin Human actrapid - 16 IU/TI

Question 5 

Reflection on a personal case experience 

 Recently we are showm a case , of an 12 yr old boy came to the hospital  in mild conscious state and he was unable to walk properly 

    His history revealed that   he was unable to run normally like other children in the school 

              Patient is mal nourished, he was lean 

    And was unconscious  , and he  had an accident in the past for which his both the upper limbs were surgically removed 

                    I myself found this case very interesting and thought to share .

                                    Thanku