Bimonthly blended assessment - June 2021
Name: Venkata Meghana Badam
Roll No: 146
Batch: 2019 (3rd Sem)
Question No: 1
1. Pulmonology:
Case: https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html
The Patient came to the hospital with the chief complaints of shortness of breath, pedal edema, facial puffiness, decreased urine output, drowsiness and chest pain. After all required investigations she diagnosed as exacerbation of COPD associated with right heart failure and bronchiectasis. Diuretics, Steroids and antibiotics are used for treating the symptoms. The case was explained well and treatment for all the symptoms was given properly.
2. Neurology:
The Patient came to the hospital with the chief complaints of irrelevant talking, decreased food intake and short term memory loss since 9 days. History of 2-3 episodes of seizures, due to alcohol consumption. After all systemic examination and lab investigations, he diagnosed as wernicke's encephalopathy secondary to chronic alcohol dependence, uraemic ensephalopathy, alcohol withdrawal delirium. The case was explained well with the reports and images. The presentation was clear and acurate.
3. Cardiology:
The Patient came to the hospital with the chief complaints of shortness of breath, chest pain, pedal edema and facial puffiness. He is a chronic smoker and alcoholic. After all investigations he diagnosed as acute pericarditis with moderate pericardial effusion secondary to post viral? post MI. The was explained well with the lab investigation.
4. Gastroenterology:
The Patient came to the hospital with the chief complaints of pain abdomen, Vomting since 1 week, Constipation, Burning Micturition and fever since 4 days. After all investigations he diagnosed as acute on chronic pancreatitis with pseudocyst and acute infective peri pancreatic fluid collections, moderate left pleural effusion with basal atelectasis, left pneumothorax, secondary to broncho pleural fistula. The presentation was clear and well explained.
5. Nephrology (and Urology):
The Patient came to the hospital with the chief complaints of fever since 4 days, pus in the urine. previously he presented with multiple complaints like drowsiness, excessive sleep, burning micturition, suprapubic pain and dribbling urine. prostamegaly was seen. After all the investigations he diagnosed as 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 sore. Treatment for all the symptoms was given.
6. Infectious Diseases(HI virus, Mycobacteria, Gastroenterology,pulmonogy):
The Patient came to the hospital with the chief complaints of difficuilty in swallowing, fever and cough since 2 months. Weight loss of 10kgs, Hoarseness of voice, inadequate sleep since 2 months. After all examination and investigations she diagnosed
14/05/2021:
40/female with RVD since 2 months on ART with dysphagia secondary to Esophageal Candidiasis ?Tracheoesophageal fistula ? Stricture
It can be any of the above diagnosis
22/05/2021:
40/female with RVD with DISSEMINATED TB with TEF 2° to ? TV/MALIGNANCY with ANAPHYLAXIS 2° to radio contrast (resolving).
Presentation was well explained.
7. Infectious Diseases and Hepatology:
The patient came to the hospital with the chief complaints of pain abdomen since 1week,decrease appetite since 1week ,fever since 4 days.He is chronic alcoholic since 30 yrs.
After all the investigations, systemic examination he diagnosed as liver abscess.The symptoms were treated and adviised medications on discharge and weekly follow up
8. Neurology:
The patient came to the hospital with the chief complaints of slurring speech ,deviation of mouth. He has postural instability, vomiting. After all systemic examination and investigations he diagnosed as cerebellar ataxia secondary to acute cerebrovascular accident (CVA) with infract in the right inferior cerebellar hemisphere. the presentation was accurate and clear.
9. Cardiology:
The patient came to the hospital with the chief complaints of shortness of breath since 1/2 hr.she has TB diagnosed 7 months ago. After all investigations she diagnosed as acute coronary syndrome (NSTEM).The patient was then advised to shift to a HC for PCI,but pci was not done bcz of no vacancy.she shifted to another hospital for further treatment.The presentation was good.
10. Infectious disease(Mucormycosis,Ophthalmology,Otorhlnolaryngology,Neurology):
The patient came to the hospital with the chief complaints of fever since 10 days ,fascial puffiness,periorbital edema since 4 days,weakness of right upper limb and lower limb since 4 days,altered sensorium since 2 days.day1 evng serious discharge from left eye. After all investigations he diagnosed as ACUTE ORO RHINO ORBITAL MUCORMYCOSIS WITH DIABETIC KETO ACIDOSIS WITH RIGHT SIDED CVA (ACUTE INFARCT IN LEFT FRONTAL AND TEMPORAL LOBE) WITH DENOVO DETECTED DIABETES MELLITUS 2 WITH AKI AND HYPERTENSION SINCE 2 YEARS. the explaination was very well,treatment for the symptoms was given,presentation was clear
Question No-2:
I haven't got the chance.
Question No-3:
The patient presented to casuality with complaints of sudden fall followed by weakness of both the lower limbs (paraplegia) and loss of hand grip, associated with bowel and bladder incontinence.He developed generalised weakness and myalgia,cough,low grade fever which he under went sputum studies and tested positive for AFB bacilli and started ATT-HRZE regimen,2 tab according to weight/PO/OD.He is a known case of TB since 1 month. After all the investigations he diagnosed as quadreparesis secondary to infectious spondylitis of C4,C5,C6,C7,and D1 with Epidural abscess at C5-C6 level
Question No-4:
The patient with chief complaints of abdominal distension and shortness of breath.Hypothyroidism since 5 yrs .she was thyronom100mg OD for hypothyroidism.After all ivestigations she diagnosed as HFrEF with Atrial fibrillation 2to ? IHD.Her biochemical report showing severe hpothyroidism possibly relating to her refractory atrial fribrillation ad attempted for defribrillation.she had low bp .There is no mention of thyroid test reports ,may be performing thyroid test earlier could have been liife saving.
Question No-5:
last month we just began our clinical postings through online.First time it is very difficult for us,but with this blogs we are atleast knowing the basic things like history taking etc.Due do this pandemic our learing became very tough bcz everything is online. our professors ,pgs ,interns helping us to learn subject through blogs . we are unable to attend offline postings in this situation eblogs are very helpful as we are taking up a case.Our HOD of general medicine exaplaining each and every case. Thank you general medicine department for this eblog idea and helping us to learn
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