BIMONTHLY BLENDED ASSESSMENT-JULY 2021
                                                                                                -103 CH.PAVAN SESHA SAI

BELOW IS THE LINK TO THE QUESTIONS ASKED TO US :

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

For the peer review i chose 101 rakesh's elog:-
1:The review is presented in brief and very well described. A detailed pinpoint review to each case which help in easy analysis. Even though the peer review was short they are well described 

2:Review of different cases like pulmonology ,cardiology ,nephrology ,hepatic diseases are well described.

3:All the reviews are brief and the investigations are described for understanding of the case.

4: 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.

QUESTION 3
Peer review of patient centered data around the theme of renal failure patients with AKI, CKD and acute on CKD, captured by students from 2016 and 2019 batch

patients history of present and past illness is well described. All the examinations and investigations are provided and thoroughly updated, provisional diagnosis and treatment is mentioned.

the case is very well presented all the investigations are provided, and the diagnosis is thoroughly updated. 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.

General and systemic examination is to the point, pictures and histological presentations is good and the serological findings are good.

4:Patient with coma and renal failure case 
History of present and past illness is coherent and well established. Investigations showing ECHO and related photos are remarkable.The videos are are great for understanding of case.
It would be better if text would be highlighted better and use some colors for headings. Overall the case is well written and easily understandable.

All the points are coherent and comprehensive, the matter is easy to understand. HFrEF secondary to CAD is the diagnosis.

6:Patient with coma and renal failure casehttps://pallavi191.blogspot.com/2021/06/gm-cases_30.html?m=1
All the data of the patient is in correct order and correctly arranged .The usage of text can be better.The highlighted text is easy to understand.

7:Patient with acute on CKD case
Patient history is well explained, the personal history, systemic and clinical examination is well presented. Treatment is in orderly manner.

X-rays and photos give better insight about the case and patient. Alcoholic hepatitis occurred as because of consuming alcohol previously.

History of present and past illness is well defined. Complete urine examination and the data of ECG and the ultrasound imaging's and findings are well done.

10:Patient with AKI case
Pancreatitis occurred due to chronic alcoholism. Many investigations are done including ultrasound to get a detailed view of the liver and if condition due to alcoholism.


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
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 upto 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: 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-6

Diagnosis: INFECTIVE ENDOCARDITIS
Treatment:
1. Inj. Monocef 1gm IV/BD
2. Inj. Vancomycin 500mg IV/BD in 100ml NS over 1hr
3. Proctoclysis enema
4. Inj. Pan 40 mg Iv/OD

CASE-7

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-8

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-9

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

CASE-10

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

These COVID times have been really tough and since the beginning clinical aspect has not been my strong hold, but since it has been more or less than 3-4 months since the beginning of the second year doing e-logs is a bit difficult during this time as we are not able to directly interact with the patient due to lack of interaction, but we are trying our level best to present our logs. Interns, pg's and faculty of general medicine  are helping us to understand the case during our online classes, but there have been times i faced some troubles due to connectivity issues and due to high level of clinical concepts it has been hard to comprehend the subject, we will try to cope up with the subject and will try to be in contact with the interns and faculty and get the jist of the subject as soon as possible .


Comments

Post a Comment

Popular posts from this blog

Image
  This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan. This blog is done by 103.Pavan & 104.Jeshmitha A 55yr old female resident of chityal with history of seizures  Chief complaints:- The patient was brought to casuality with chief complaints of Active involuntary movements ,since 30 minutes, history of frothing from mouth deviation of eyeball upwards ,tongue bite with urinary incont
Read more
 Learning points:- I have learned about treatment plan of epilepsy  Mechanism of action of phenytoin in epilepsy Maintenance and loading dose in epilepsy Adverse effects of phenytoin in therapeutic range Importance of levitriacetam in status epilepticus I have learned how to auscultate bronchial breath sounds In community acquired pneumonia case:-Characteristic difference between inspiratory and expiratory sounds of bronchial breath sounds(inspiration- gushing expiratory-hollow) In CKD case:- how to examine distended abdomen, how to perform fluid thrill, how to perform shifting dullness  OSCE:- -causes of unexplained onset of seizures in adults  various structural and functional causes can be responsible for late onset of seizures with unexplained origin -cerebral small vessel ischemic disease  -accumulation of amyloid beta - hyperphosphorylated tau -sleep apnea https://pubmed.ncbi.nlm.nih.gov/31481308/ IDIOPATHIC GENERALISED EPILEPSY While late-onset IGE (IGE with an age at onset of a
Read more
Image
  This is an online e-log platform to discuss case scenario of a patient with their guardians permission.   I have been given this case to solve in an attempt to understand the topic of patient clinical data analysis to develop my competency in reading and comprehending clinical data including, history, clinical findings ,investigations, come up with a diagnosis and treatment plan. Chief complaints: A 17 yr old girl from Suryapet came with the chief complaints of fever,weakness and pain in the legs. History of presenting illness: Patient was apparently asymptomatic 5 days back then she developed fever which is of high grade not associated with chills and rigor and fever is continuous and relieved on taking medication and developed generalised weakness and dragging type of pain of both lower limbs since 5 days. No h/o shortness of breath, palpitations and chestpain No h/o pain in the abdomen,vomiting,loose stools No h/o cough,cold No h/o burning micturition and hematuria. History of pas
Read more