General Medicine Monthly Assignment (July 2021)

Name   : Jella Mounika

Roll No :51

Batch    :2019(3rd semester) 

 I have been given the following assessment to analyze and review, in an attempt to understand the topic of patient 'clinical data analysis' to develop my competency in reading. This is the link regarding assessment: 

http://medicinedepartment.blogspot.com/2021/07/medicine-paper-for-july-2021-bimonthly.html?m=1

QUESTION 01: competency tested for peer to peer review and assessment

Review on the answers of roll no-52

Case reviews-

He has gone through the patient case details 
and assignment done by our seniors  who has explained etiology and comprehended clinical data including history taking, investigations and they come up with treatment plan.He gave description about evolution of symptomatology, and has given a short review about assessment.He mentioned the cause,he also dissussed about investigations that has done to know the root cause and medications that were given to patient.After the patient symptomatology, he would have been included pathophysiology behind the symptoms of each disease of the case that he reviewed in his answers instead of elaborating patient history details which were already there . Apart from that, I feel everything was well and good . Nice part in his reviews is that he has suggested advices that patient might has taken in the course of his / her treatment and management of disease in order to avoid complications and re-occurance. 

Case presentation-

Link to his blog

Positives:

He has presented case with all subheadings included like history of present illness,past illness, personal history, family history, physical examination and provisional diagnosis.

Negatives:

He does not placed images of investigations that were  ordered for given patient such as complete urine  examination, ECG, Ultrasound.etc

For the patient suffering with Acute kidney injury serum creatinine, blood urea, serum electrolytes, serum potassium examinations were very important for diagnosis and management but he does not put all those in his e-log .

Dated medications might have been included at the end that gives clear picture how patient has been treated.

Case analysis- 

Link to the case that he has analysed

https://nikithaedam48.blogspot.com/2021/06/18-year-old-malefrom-miryalagudawho-is.html?m=1

It was the case of the patient suffering from Acute viral hepatitis associated with diabetic ketoacidosis.He went through the patient details and provisional diagnosis. He justified the diagnosis given by the case author by his explanation. He also mentioned why patient has urged to appear to opd . He alo mentioned the results of investigations that are done and included advices that are given to the patient.


In short about my peer e-log:

Even though we were first to appear for this type of telemedicine and making blogs ,he has  put his greatest effort to emphasize and  strengthen his e-log through various sources. He is really good in understanding and comprehending the patient centered  data analysis.Finally, having a hope of  improvizing  our standards  in further case scenarios.


Question 02:  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 . 

Link to my E-log:
1) 
https://51mounikajella.blogspot.com/2021/07/gm-e-log-j-mounika-roll51.html

2)https://51mounikajella.blogspot.com/2021/07/gm-e-log-j-mounika-roll-51.html

Question 3- Testing peer review competency of the examinees.

Question 04: Testing Scholarship competency for examinees

Answer: I have been provided with case studies and I 'll be reviewing that including problems and treatment plan involved in the case. 

 Link to the case on AKI:

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


Other Patients with AKI :





In these cases of  Acute renal injury , the major causes are heavy blood loss,an injury or a bad infection  which makes serious drop in blood flow to the kidneys. 

Case sheets are good,as all patient data has been sufficiently deidentified. Personal history ,past history  and treatment history are very detailed. Diagnostic reports and images are clear and are explained too. Provisional diagnosis was correctly made.

Problems:
Lower abdominal pain
 burning micturition 
dribbling urine
 right heart failure
Elevated creatinine
Chest pain

Solutions: 
Haemodialysis
 Tablet tramadol 
IV piptaz
Tab Nicordia, Nodoeis
 injection Tarzan 2.25 g IV per TD

Patient with coma and renal failure  :



In these cases,patients are suffering from renal failure. the etiology involved in this is physical injuries or other diseases.All the patients in the case scenarios have diabetes and high blood pressure which paved way for development of renal failure.

Diagnosis of the case is appropriate and case was formatted in a good manner. Also Provided all the investigations and treatment plan upto date.

Problems and solutions:
Constipation
Altered sleep pattern 
Alcoholic liver disease- thiamine
Diabetic nephropathy- hemodialysis
Hepatic encephalopathy
Fever,pain in abdomen- tab pantop


Patients with acute on CKD :






Chronic kidney disease (CKD) this was mainly due to hypertension and increased blood sugar levels. All these cases complications ate worsened because patients are delayed in admitting the hospital.To keep their kidneys healthy, patients  should make healthy food choices, and make physical activity in their routine life. 
Case details were formatted in an sequential order. Addictions ,treatment plan were mentioned in every case report. 
   
Problems and solutions:
Chronic renal failure
Increased BP- Gliciazide
Vomiting- IV fluids,lasix

QUESTION 05:Testing scholarship competency in logging reflective observations

Firstly, it was fortune to have a look on various case scenarios on same disease (kidney failure) 
So that we'll get wide  perspective on treating and managing the disease.  I learnt a lot from this e-log and has put my effort to strengthen my assignment by gaining knowledge from our seniours and my peer group.This type of clinical exposure has made possible only because of our HOD sir, from GM department, who has assigned to do this. 

Even though Telemedicine has improved our clinical skills but meeting the patient in person is very helpful in improving our knowledge on clinicals. We were excited to learn from clinical postings once we back to college. 

Thank you for interns, to the GM department who has helped. 
















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