Bimonthly blended assessment for june 2021
P. Nikitha
Roll no :102
3rd sem(2019 batch)
I have been given the following formative assessment for bimonthly blended assessment for June 2021 .This is the link regarding assessment:
https://medicinedepartment.blogspot.com/2021/06/medicine-department-paper-for-june-2021.html?m=1
Question 1 :- Competency tested for Peer to peer review and assessment :
1)
Case:
https://143vibhahegde.blogspot.com/2021/05/wernickes-encephalopathy.html
Review:
https://blendedasessmentmadhukumar.blogspot.com/2021/05/medicine-blended-assesment-may.html
Patient came to opd with chief complaints of Ir-relevent talking and decrease food intake from past 9 days, he is an alcoholic, and also had history of siezures so the provisional diagnosis is wernick's encephalopathy Or alcohol withdrawal syndrome..
The answers given to the questions are very detailed. Mechanism of action, indication and efficacy over placebo of each of the pharmacological and non pharmacological interventions used for this patient are explained very clearly.. Cause for normocytic anemia is not explained clearly.. Rest everything is clearly explained and easy to understand
2)
Case:
https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html
Review:
https://preethicheera.blogspot.com/2021/05/general-medicine-case-presentation-may.html?m=1
Patient came to opd with the chief complaints of shortness of breath, pedal edema and facial puffiness.provisional diagnosis is Acute exacerbation of COPD associated with right heart failure and bronchiectasis.
Answers given to the questions are good.
Evolution of symptomatology is explained in detail.but etiology is not explained. Anatomical location is mentioned. Mechanism of action, indications and efficacy of various drugs are explained in detail. Electrolyte imbalance causes and danger is explained clearly. Overall it's a good presentation.
3)
Case:
http://manikaraovinay.blogspot.com/2021/05/50male-came-in-altered-sensorium.html
Review:
https://chennabhavana.blogspot.com/2021/05/general-medicine-blended-assignment.html
A male patient came to opd with chief complaint of altered sensorium. It is condition of mucormycosis.
In the answers symptomatology is clearly explained including with dates and days. Anatomical localisation is mentioned. Interesting point is loading dose and maintaining doses of injection are mentioned.. And they even made a note on affordability issues of medicine.. And the reasons for high cases of mucormycosis in India are given in detail and prevention is also mentioned.. It's a clean presentation.
4)
Case:
http://bejugamomnivasguptha.blogspot.com/2021/05/a-45-years-old-female-patient-with.html
Review:
https://divyaraju266.blogspot.com/2021/05/answers.html
Patient came to opd with chief complaints of palpitations, pedal oedema, chest heaviness, radiating pain along the left upper limb. Patient was diagnosed with cervical spondylosis and recurrent hypokalemic paralysis.
About the answers given..anatomical localisation is mentioned and primary etiology is discussed deeply.. And causes of the symptoms are explained and possibility of other diseases are mentioned. Tables are used to explain clearly.. Risk factors of hypokalemia are mentioned and ecg changes in hypokalemia are explained with diagram. Usage of tables and diagrams made this presentation a bit more effective.
5)
Case:
https://nikhilasampathkumar.blogspot.com/2021/05/a-48-year-old-male-with-seizures-and.html?m=1
Review:
https://chippaakhila23.blogspot.com/2021/05/online-medicine-blended-assignment-may.html
Patient was taken to hospital with Chief complaints of unresponsiveness for 7 hours and 3 intermittent episodes of seizures in the past 3 hours. After various examinations. Provisional diagnosis was
Generalized tonic-clonic seizures secondary to acute hemorrhage in the frontal, temporal, and parietal lobes .
In the answers the various possible reasons for ataxia are mentioned like alcohol consumption and about peripheral neuropathy. Bleeding diathesis related to chronic alcoholism is explained. And the reason for his IC bleed is not explained in detail.
6)
Case:
http://shivanireddymedicalcasediscussion.blogspot.com/2021/05/a-30-yr-old-male-patient-with-weakness.html
Review:
http://santhoshdarimedi.blogspot.com/2021/05/medicine-blended-assignment.html
Patient came to opd with weakness of right upper limb and lower limb and deviation of mouth to left after a fall. And the diagnosis was Right sided cerebrovascular accident with a cute infarct in left MCA territory.
Answers given are very short and accurate.. Said there is no connection with past accident and all the warning signs of CVA are explained. And the drug rationale is mentioned. And the possibility of alcoholism leading to this condition is explained. Lipid profile is discussed as a reason for etiology of attack... Answers are short and clear.
7)
Case:
https://amishajaiswal03eloggm.blogspot.com/2021/05/a-50-year-old-patient-with-cervical.html
Review:
https://rishithareddy30.blogspot.com/2021/05/covid-cases-elog.html
This is a case of a patient with cervical Myelopathy.patient came to hospital with complaints of weakness of all 4 limbs preceeding alcohol binge and fall.
In the answers
Condition of Myelopathy hand is defined clearly and pyramidal tracts are also mentioned.. I would be better if used a picture of this condition. Finger escape condition is explained and the nerves and muscles involved are also explained. And how finger escape is seen in cervical Myelopathy is also explained. Hoff mans reflex is also explained.. The explanation part is good.. But if diagrams are inserted it would be much more easier for understanding.
8)
Case:
https://muskaangoyal.blogspot.com/2021/05/a-73-year-old-male-patient-with-pedal.html
Review:
https://supriyakammari53.blogspot.com/2021/05/medicine-blended-assignment-may-2021.html
This is a case if heart failure. Patient came to opd with pedal edema, shortness of breath and decreased urine output. Onn examination Patient is diagnosed with heart failure with preserved ejection fraction, diabetes, hypertension, left LL ulcer, diabetic trio pathy.
In the answers various possible causes for heart failure are explained in detail like alcohol consumption, high BP, renal diseases. Reason for anemia in this case is explained very clearly. Different Stages of diabetes seen in this patient are explained.. And the reference links used are also mentioned so it is useful.
9) Case:
https://daddalavineeshachowdary.blogspot.com/2021/05/67-year-old-patient-with-acute-coronary.html?m=1
Review:
https://sudhamshireddy.blogspot.com/2021/05/medicine-blended-bimonthly-assignment.html
The case is about 67 old patient with acute coronary syndrome.
In the answers..
The symptomatology is explained clearly using a flowchart. Anatomical localisation is mentioned. And etiology is explained in detail. Pharmacological interventions are explained well.. Beta blockers actions are mentioned. Also explained about non pharmacological interventions about the percutaneous coronary intervention in detail. Indications and contradictions of PCI are covered. Complications of PCI are mentioned and also mentioned that the cost of this test is high and burdensome. Overall answers are good... I guess Mechanism of action should be explained much more clearly.
10)
Case:
https://kausalyavarma.blogspot.com/2021/05/a-52-year-old-male-with-cerebellar.html?m=1
Review:
https://jahnavichatla.blogspot.com/2021/05/Jahnavi%20Online%20blended%20Bimonthly%20Assessment-%20May.html
Patient came to old with slurring of speech and deviation of mouth that lasted for 1 day and resolved on the same day. Patient was found to have de novo HTN, and he did not continue taking medication regularly and the provisional diagnosis is Cerebellar Ataxia secondary to Acute Cerebrovascular Accident (CVA) with infarct in the right inferior cerebellar hemisphere.
Answers given for the questions are very well presented.. Symptomatology is explained clearly using flow chart. Anatomical localisation is clearly explained.
Mechanism of action and efficacy of drugs used is explained in detail.placebo effect is explained. Types of strokes and relationship with alcohal is explained. Adverse effects of alcohol consumption is explained.. It's a very good presentation, it's clean and easily understandable.
https://pallavi191.blogspot.com/2021/06/gm-cases.html?m=1
So the presentation of the case is complete.
Because they started with
Chief complaint, and mentioned about history of present illness, history of past illness, personal history,family history.
General examination, systemic examinations are done, they also inserted the de-identified
Pictures of patient, reports of other investigations done and the ecg reports, x rays are also uploaded. They also mentioned about the medicines used. They also given clear information about the treatment done each day until the discharge. MRI report is also uploaded which gives information about the clinical diagnosis. At the end advice is also given on future treatment. So the e-log is complete in details.
Coming to the correctness of the case,as am a 3rd sem student I can't clearly comment on this. But with the knowledge I had,the patient is treated correctly, and even he is also adviced to meet higher center for further complete treatment.
And of course the investigations done are very important leads in diagnosing the disease and in ruling out things.
Question 4:-
I took the following case to answer the question:
https://casescape.blogspot.com/2021/06/acute-kidney-injury-secondary-to.html?m=1
Problems:
Pedel edema
Fever
DM2
Acute kidney injury secondary to urosepsis
On investigations we also found that patient is anemic and had hyperkalemia.
Treatment :
- inj. Lasix - to treat fluid retention and pedal edema caused due to kidney disease.
-Antipyretics like ultracet are used to control fever.
- diabetes is already a known one so may be same medication is continued.
- inj. Magnexforte and tab-norflox to treat urosepsis
-tab orofer - for treatment and prevention of different types of anaemias .
-hyperkalemia is also resolved in this patient
Question 5:-Testing scholarship competency in logging reflective observations on your concrete experiences of this last month :
It's been nearly a month into our second year and due to this pandemic we are having online classes. And the clinical postings too were online.
In the beginning all the new subjects, online classes, online postings and Everything are too confusing to us.. Now we are slowly adjusted to it. We are learning about tele medication.
Actually every medical student obviously gets excited to see and talk to their patients.But we are missing our physical presence there. But our professors, seniors are really trying very hard to make us understand the things. So we are experiencing new things.
In the initial days it was all like Greek and latin to me. Different kinds of patients their problems and the investigations to be done and about the medications. But now am used to all those because of our group discussions in whatsApp with our professors and while referring to the various e-logs made by our seniors all these things helped us to get into track.. So now I learnt how to take history of a patient,what kind of questions to be asked. In coming days I will be making my own e-log so that I can communicate with the patient/patient's attender and take history myself and will try to understand and diagnose the case.
My unforgettable experience in the clinical postings is one day during our virtual clinical postings while we are discussing about many patients there in ICU.. Suddenly a patient condition got worsen and pgs immediately started doing CPR.. Though CPR is a common thing.. It felt different to see it in live... The amount of work they are putting in and the tension in their faces and the serious atmosphere present in the ICUs..
on the other day, while our professor is trying to test knee jerk reflex in a patient. The is patient is resisting due to fear of pain. Here one of the pgs diverted the patient by talking with them. This incident is an example to us to learn how to tackle with the patients for efficient diagnosis and treatment.
Finally this tele medical learning is good in these circumstances. But we are eagerly waiting for our physical presence there in the wards.
I want to thank Dr. Rakesh biswas sir and all pgs, interns of general medicine department for helping and guiding us.
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