GENERAL MEDICINE...

 

Online bimonthly assignment

Ch. Naga Tarun
3rd semester
Roll no. 27


We have been given 5 questions as an assignment  to analyze,acess , understand and write the preview of the cases.

QUESTION 1:

Below is the link of  the student for which I am giving my peer review

https://lasyaakula25.blogspot.com/2021/07/04-srilasya-akula.html

Review to all the questions answered:

1}As she done about 10 cases, in each case she given a best review, which was very useful for us to understand about the case details.


2}She gone with good investigations and given a better explanation for every case. And she followed steps in investigations, She also used grades for each case.


3}Everything was fine and fare, but little more explanation is needed for every case which I thought personally, other than that every case she explained is very nice.


5}My overall review about the cases she reviewed was good. we

 get better understanding by studying the cases which she mentioned.

QUESTION 2:

i dint get any case until now , looking forward to investigate a case .


QUESTION 3:

CASE NO :1

                                                      AKI

CASE LINK:

INSIGHTS:

Histories personal present and past have been taken in chronological order.Diagnosis and treatment must have been explained a little more. How was the lower back pain ruled out is also not explained.

CASE NO :2

                                                      ACUTE ON CKD

CASE LINK: 

INSIGHTS:

The evolution of symptomatology could've been in order . Treatment is given in order date by date which makes it easier to look for . And the history of patient is described well . Treatment history could've been mentioned. Investigations done are proper and the provisional diagnosis also is being explained well by them .

CASE NO :3

                                                      CKD

CASE LINK: 

INSIGHTS:

The case was comprehensive and concise and we'll be excreted. All the necessary information was provided and even the investigation with reports and histology slides of the plasma cells was also uploaded.Discharge date and summary mentioning must also be considered important.

CASE NO :4

                                COMA AND RENAL FAILURE

CASE LINK:

INSIGHTS:

Day to day treatment details are mentioned clearly . Pictures are also included , detailed reports have been provided . But history and treatment have been repeated . Log was very impressive . diagnosis should have been more clear.

CASE NO :5

                                       COMA AND RENAL FAILURE

CASE LINK:

INSIGHTS:

The case is well explained with pictorial depictions, and the vedioes of 2 d echoes were also provided. A detailed treatment plan is given. Details of discharge summary and treatment faculty have been provided . Pictures , videos were included . Advice at discharge is also mentioned .But drug history has not been mentioned. 

CASE NO :6

                                                ACUTE ON CKD

CASE LINK:

INSIGHTS:

The log was exceptionally done .it is clear and precise. Comparisons between before and after treatment were done and the diagnosis was made clear.

CASE NO :7

                                                ACUTE ON CKD

CASE LINK:

INSIGHTS:

Well presented blog . It was clear and comprehensive . Important details have  been highlighted . Necessary links have also been provided .

CASE NO :8

                                                ACUTE ON CKD

CASE LINK:

INSIGHTS:

The case was not so clear as there were many assumptions in the condition and the patient was symptomatically treated.Discharge summary is not mentioned .

CASE NO :9

                                                         AKI

CASE LINK:

INSIGHTS:

The case is done precisely with chronological history and day-wise observations and treatment. the case is clear and pictorially assisted well. Present, past, family history have been mentioned. Pictures of general examination have also been provided. 

CASE NO :10

                                                         AKI

CASE LINK:

INSIGHTS:

Log was Impressive. The information was clear. It is well assisted with pictures. Treatment and diagnosis are well mentioned. All the required investigation reports and details are provided. 

CASE NO :11

                                                         AKI

CASE LINK:

INSIGHTS:

Log was clear and precise .Day to day treatment have been mentioned. All the necessary details are mentioned. The case summary has also been provided wich helps in easy understanding. The log was clear and precise. the case summary has been provided which helps in easier understanding.


QUESTION 4:

✱Case 1
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  IN  100ml   NS   IV/TID

✱Case 2
Diagnosis : Hyperuricemia 2° to Renal failure 
Treatment:
• IVF -    NS-0.9%  @100ml/hr
• Inj. Tazar 2.25gm I.V -TID 
• Inj. Lasik 40mg I.V -BD 

✱Case 3
Diagnosis:  Chronic interstitial nephritis secondary to plasma cell dyscariasis
Treatment:   
- T. PAN 40mg /PO / OD
- oral fluids up to 1.5 - 2 lit / day
- Protein - x ( plant based ) 2 tablespoon   in 1 glass of  milk  

✱Case 4 
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 
Diagnosis: Renal AKI secondary to urosepsis with b/L hydroureteronephrosis
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

✱Case 7
Diagnosis: HFrEF secondary to CAD; CRF
Treatment: 
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

✱Case 8
Diagnosis: 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.

✱Case 9
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
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:

I have learned many things during the online clinical sessions. I  got a chance to log for a case, the experience was quite helpful for me in understand how the system works. Our assigned interns were very cooperative and helped in making the elogs. General Medicine department has put in lots of efforts to make the online teaching process much more effective and productive. This online experience will definitely make our offline postings easier. This way of learning helped us in getting exposure to different cases , their diagnosis and treatment. I am very thankful to the GM department for their efforts in making our learning process easier and more interesting. 

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