General medicine assessment
General medicine assignment
125 Afrin shaik ( 3rd sem )
Question . 1
1 Case: Pulmonology
: https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html
As chief complaints are pedal edema facial puffiness and shortness of breath for the past 15 days .As far the examinations done and investigations revealed that she is suffering from an exacerbation of COPD along with right heart failure associated with bronchiectasis.
2Case : Neurology
https://143vibhahegde.blogspot.com/2021/05/wernickes-encephalopathy.html
As the patient has been presented to the hospital with chief complaints of irrelevant talking and decreased food intake for 9 days .after lab investigations and radiological reports and the person is diagnosed with wernickes encephalopathy secondary to chronic alcohol dependence. Wernickes area is normal in the temporal lobe on the left side of the brain and is responsible for the comprehension of speech.
3 Case: Gastroenterology
https://vyshnavikonakalla.blogspot.com/2021/05/a-40-year-old-lady-with-dysphagia-fever.html
This is could be a case of tracheoesophageal fistula or oral candidiasis or oesophageal strictures. Tracheoesophageal fistula which is a congenital defect which causes the trachea and oesophagus to have communicating pathway between them causing the contents of both structures to mix resulting in symptoms such as dysphagia ,cough and sputum. It could also be oral candidiasis or oesophageal strictures. She also has AIDS. The presenting symptoms can be due to opportunistic infections. Anti retroviral therapy with other required regimen was given. It should be noted that she is TB positive. Given the illness , it is unlikely that she will recover and her AIDS will progress and prove to be fatal. All we can do is make sure we treat the associated ailments to make her life comfortable.
4Case : Infectious disease and hepatology
https://kavyasamudrala.blogspot.com/2021/05/liver-abscess.html
This is a case of liver abscess. Given that the patient is a chronic alcoholic and heavy smoker , liver disease are likely. The culture report showed that he is infected with methicillin sensitive Staphylococcus aureus to which the treatment regimen was followed. The following hospital stay included antibiotic therapy and an advice for pigtail catheterization was given but later on it was found that the abscess was not drainable . The symptoms were treated and medication was advised on discharge .The patient was treated to the best of available resources but a more permanent solution for the liver abscess should be found. High fat meals can precipitate severe symptoms in patients with liver abcesses and that should be considered. A more permanent solution would provide any future distress that maybe experienced by this patient.
5 Case :Cardiology
https://preityarlagadda.blogspot.com/2021/05/biatrial-thrombus-in-52yr-old-male.html
This is a case of atrial fibrillation and bilateral thrombus. The patient presented with shortness of breath, decreased urine output and anuria. Upon investigations, s.creatine and b.urea were elevated. 2 D echo showed dilated heart function with severe lv dysfunction. Renal function tests were also impaired. Cardio renal syndrome was suspected. Several symptoms were treated using appropriate medication and the patient's condition improved and he was discharged.Loss of Atrial contraction and Left atrial dilatation causes stasis of blood in the LA and may lead to Thrombus formation in the Left Atrial Appendage. This predisposes patients to stroke and other forms of systemic embolism. The patient was treated satisfactorily and his recovery will depend on his adherence to the medication which was given upon discharge.
6 Case : Neurology
https://amishajaiswal03eloggm.blogspot.com/2021/05/a-50-year-old-patient-with-cervical.html
This is a case of cervical myelopathy presenting with weakness in all four limbs. He is a known case of hypertension and is on regular medication. After the necessary investigations were done, C3-C6 OPLL that is osteomalacial changes were seen and referred for neurosurgical intervention. Quadriparesis and hypokalemia were also seen. Finger escape sign was seen. Wartenberg's sign is a neurological sign consisting of involuntary abduction of the fifth (little) finger, caused by unopposed action of the extensor digiti minimi. . This finding of weak finger adduction in cervical myelopathy is also called the "finger escape sign"The required treatment inculding steroids , vitamin supplementation were given. Surgery was advised for a better routine life. The treatment of this patient was adequate along with long term option of surgical intervention gave the patient adequate solution.
7 Case :Heart failure with diabetes
https://muskaangoyal.blogspot.com/
A 73 year old male presented with pedal edema, shortness of breath, decreased urine output. He is a chronic alcoholic and has pedal edema since 4 years, burning vision since 4years .decreased urine output sincce 2days .the diet he was talking is a normal mixed diet, appetite was normal, normal bowel movement but there is decreased urine output.
On general examination he was said to be pallor and pedal edema but not icterus ,cyanosis,clubbing ,lymphadeonopathy.
He is heavily built with central truncated obesity and a ulcer on left limb. Vitals were abnormal.
8 Case: Gastroenterology
:https://caseopinionsbyrollno110.blogspot.com/2021/05/i-h-ave-been-given-following-cases-to.html?m=1
flowcharts were included wherever necessary, the answers were upto the mark,to the point, detailed explaination, easy to understand .
9 case :Cerebellar ataxia
https://kausalyavarma.blogspot.com/
A 52 year old male presented with giddiness associated with one episode of vomiting there is a lesion in cerebellum. There is presence of infract in inferior cerebellar hemisphere of the brain. Symptoms are loss of muscle control coordination of voluntary movements such as walking and picking up of objects. International tremors. There is deprived of nutrients and oxygen to the brain the treatment was good. Investigations done are CT scan, LFT, RFT, CUE.
10 Case:Pulmonology
https://54tejasreekandregula.blogspot.com/2021/06/70-year-old-male-with-fever.html
This is a case of viral pneumonia secondary to COVID -19. Given the ongoing pandemic situation, this patient tested positive for COVID -19 and was admitte.Further investigations revealed impaired CBP and respiratory exam was abnormal with vesicular sounds. Steroids were given along with additional O2 , nebuliation and antipyretics. Vitamins were also prescribed. And patient was subsequently discharged upon betterment. The SARS-Cov-2 virus has been rapidly spreading causing respiratory distress progressing to ARDS and proving fatal. The medical intervention for this patient was given before the symptoms worsened to an irreversible state and the patient got better. Appropriate treatment at the earliest is the best way to deal with the ongoing pandemic. Patient should be quarantined until he becomes negative for COVID-19.
Question .2
I haven’t gotten a chance to make a case report yet.
Question. 3 CVS
A 70 year old female presented to causality with complaints of distention of abdomen and shortness of breath grade 3 since 5 days.
* The history of patient was well presented and we'll described.
* The investigations were presented in a proper format, with respective subheadings and the pictures of the report were included.
* diagnosis was mentioned.
Question .4 Abdominal
A 60 ur old female presented to the OPD with chief complaints of pedal edema since 10days decreased urine output since 10 days and fever since 10 days.
* personal history was well.
* investigations were clearly mentioned,with pictures of the report and dates on which the investigations were done .
* both general and systemic examinations details were given properly,with appropriate side headings.
* the treatment plan was well described.
* presentation was to the point, easily comprehendable.
Question. 5
Firstly it was great to have interaction with the patient although it is online. The classes were intresting but it wouldbe more effective if these sessions were done offline.This assignment has helped me learn the basics of clinical practice like the history taking, presentation of a case, how to approach a patient etc,
This pandemic had a major impact on education, we are unable to attend the offline postings and meet the patient in person, in such situation, this method of eblogs has been of great help, as we are able to take up a case, and present it in this way even though we are not present physically in the hospital, this has been a very great experience, we have learn a lot form the postings, and are hoping to learn more and more in the coming days. Our HOD sir is making classes compulsive and explaining us in an appropriate way which makes easy to understand.
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