General medicine online summative assignment (july)

          Name: Gowthami
          Roll No:132
 
QUESTION 1 

Below is the link of the student assignment for which I am sharing my peer review
Reviews to all the Questions answered :-
1) The reviews for the cases selected are well described. A detailed pinpoint review has been given to each particular case selected, which is helpful in easy analysis. Even though the peer reviews giving are short they are well described. There is even more possibility for more case depicting points which can be selectively described.

2)The overall review and personal experience review is quite good. I'm sure that the patient centered approach of collecting and learning data has been well grasped by the student.  

3)Review: All the investigations were listed clearly. CT scan images are clear. 

4)Patients details are not shown in any reports, x rays. Reports are not clear. 

5)Vitals are noted properly. Reports are not soo clear but, conclusion was given. Treatment line was good.


6)History taking was good. But explanation of the case was vague. Treatment line was good.


7)As a whole elog was good, understandable. Treatment line was good.

8)The reason for elevation of values was not mentioned. Diagnosis and treatment line was good.

9)The reason for elevation of biomarkers is not mentioned. Patients details are deidentified in the reports. Treatment line was good.

10)Case presentation was a little clumsy. Images were clear and explanation was good.

QUESTION 2

Below is the link of my case report of a patient that I've 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.


QUESTION 3

Case 1:-AKI   Link to the case is below :
Scenario of the case is depicted very well. Along with the treatment history and complains which are described correctly for easy analysis. Many investigations done are which are done are placed very well according to date.

Case 2:- Acute on CKD   Link to the case is below :

This is a case of chronic kidney disease. All the identifications and investigations are headed towards the disease, as he had radiating pain towards backward. All these are described very well in the log presentation.

Case 3:- CKD   Link to the case is below :
Many serological investigations are done including LFT. 2D echo, bone marrow aspiration test is also done to identify any underlying cause for this disease.

Case 4 :- Patient with acute on CKD     Link to the case is below :
Post TURP with non oliguria ATN. It is a classical case where pus is seen in urine. There is a history of Transurethral Resection of Prostrate. Hydronephrosis is beautifully explained with MRI scans.

Case 5 :-Patient with AKI   Link to the case is below :


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

⇒Pancreatitis occured due to chronic alcholism. Many investigations are done including ultrasound to get a detailed view of the liver and if condition due to alcholism.

Case 6-  Patient with AKI   Link to the case is below :

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

⇒Urosepsis is seen as there is infection of urinary tract. Generalized lymphadenopathy is present. For more information regarding urosepsis refer below link:

https://www.ncbi.nlm.nih.gov/books/NBK482344/


Case 7:- Patient with acute on CKD     Link to the case is below :

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

⇒He was suffering with decreased urine output and vomitings and loose stools which are gradually subsided. Even fever is also spiked.


QUESTION 4

CASE1 
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

CASE2
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 upto 1.5 - 2 lit / day
- Protein - x ( plant based ) 2 tablespoon   in 1 glass of  milk  

CASE4
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

CASE5
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

CASE6
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

CASE7
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

CASE8
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.

CASE9
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  

     

CASE10
Diagnosis: Acute Kidney Injury secondary to Urosepsis
Treatment:
 Inj LASIX 40mg (8am- 2pm -8pm)
IVF - NS @ UO + 50 ml/hr

CASE11
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

During the span of 2months I have experienced and seen many cases which are really helpful in clinical way. I have learned many things during the posting session.Even i have got a chance to log for a case the experience was quite helpful for me in understand how the system works. The General medicine department has done a quite a good work in making us understand the subject. For every clinical case they have guided us how to study and analize the case. I have learned how to capture the patient centred data for diagnosing the diseas. I have got a chance to see the many types of investigations done in order to diagnose a disease. I am grateful for this opportunity to involve in these study.





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