Medicine department paper for June 2021bimonthly blended assessment
Name: Jasmisri
3rd sem
Roll no:91
I HAVE BEEN FOLLOWING CASES TO UNDERSTAND THE TOPIC OF PATIENT CLINCAL DATA ANALYSIS TO DEVELOP MY COMPETENCY IN READING AND COMPREHENDING CLINICAL DATA INCLUDING HISTORY,CLINICAL FINDINGS,INVESTIGATIONS AND DIAGNOSIS AND A TREATMENT PLAN AND TO GIVE REVIEW ON THE ANSWERS OF THE RESPECTIVE CASE.
Question -1
Review to the following cases💬
https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html
💥What could be cause for her acute exacerbation?
I agree the way she answered it would be better with some visual picture of causes. As answered, cause of acute exacerbation are usually by a viral or bacterial lung infection, but they may also be triggered by things or situations that make it difficult for you to breathe, such as smoking or being exposed to smoke or air pollution
Patient is a farmer, as she exposes to infection or dust particles and also we can see similiar episodes of SOB. (2)https://aniganikavya06.blogspot.com/ 👇
Patient details in link
dhttps://amishajaiswal03eloggm.blogspot.com/2021/05/a-50-year-old-patient-with-cervical.html
💥 What is myelopathy hand?
I agree with the answer but it would be better with some picturization and proper definition I think so.
Defined some efficiently as patient has loss of power of adduction and extension of the ulnar two or three fingers and an inability to grip and release rapidly with these fingers. These changes have been termed "myelopathy hand" and appear to be due to pyramidal tract involvement.
(3)https://bejugamomnivasguptha.blogspot.com/ 👇
Patient details in link:-
https://neerajareddysingur.blogspot.com/2021/05/general-medicine-case-discussion.html?m=1
💥What are the risk factors?
I don't agree with the answer because there is no proper pointing of factors... Just picture with points doesn't look better from of answer if the picture with some identifications it would be nice.
Risk factors are not so clear so as follows
1.Pregnancy and the first few weeks after delivery2.Problems with blood clotting; for example, antiphospholipid syndrome, protein C and S deficiency, antithrombin III deficiency, lupus anticoagulant, or factor V Leiden mutation3.Cancer4.Collagen vascular diseases like lupus, Wegener’s granulomatosis,andBehcetsyndrome5.Obesity6.Low blood pressure in the brain (intracranial hypotension)7.Inflammatory bowel disease like Crohn’s disease or ulcerative colitis
4)https://preethicheera.blogspot.com/?m=1 👇
http://shivanireddymedicalcasediscussion.blogspot.com/2021/05/a-30-yr-old-male-patient-with-weakness.html
💥Does his lipid profile has any effect?
I agree with the answer ,and also if it is compared with other lipid profile which cause stroke if mentioned it would be very good in understanding ..and can be useful in other cases..
As answered ,the inverse relationship between serum HDL-C and stroke risk . When take together it seems clear that higher baseline levels of serum HDL-C lower the risk of subsequent ischemic stroke. As we know, HDL is good cholesterol, as he has high level of it so no risk of ischemic stroke. If in case LDL is high then there would be other risk to him.
5) https://saichennuru.blogspot.com/ 👇
http://shivanireddymedicalcasediscussion.blogspot.com/2021/05/a-30-yr-old-male-patient-with-weakness.html
💥What are the warning signs of CVA?
I agree with the answer, mentioned almost all signs I think but some more better explanation it would better. Patient has a road accident and his cranium has injured this may leads to problems in walking and movement, trouble in speaking , dizziness, etc.
6) https://dthanmai27.blogspot.com/ 👇
https://kausalyavarma.blogspot.com/2021/05/a-52-year-old-male-with-cerebellar.html?
m=1
💥Dose HTN cause stroke?
I agree with the answer, but if it some more elaborated it would better understandable.
Patient is having hypertension , suffering from giddiness ,slurring of speech ,and due to cerebral arteries sclerosis had stroke.
7)https://aishwaryagannoji35.blogspot.com/ 👇
https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html
💥What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the problem.
I agree with the answer, almost every symptom is explained with time period in patient terms and anatomical localization of problem ,if some more examined it would be better. Primary etiology is is mentioned. But if answer would contain flowcharts it would better understanding I think.
8)https://laharika29.blogspot.com/ 👇
https://143vibhahegde.blogspot.com/2021/05/wernickes-encephalopathy.html
💥what is the probable cause for kidney injury in this patient?
I agree with the answer, but it would be better if explained about detail in kidney function and kidney diseases.
As we know kidney plays a vital role in our for filtering, reabsorbing, excreting .
The kidneys have an important job as a filter for harmful substances .alcohol causes changes in the function of the kidneys .
Due to free radicals (produced due to break down products of Alcohol) which intern triggers tissue injury and increased inflammation.
9)https://39nagarjuna.blogspot.com/ 👇
💥what is the reason for giving thiamine in this patient?
I agree with answer ,but not explained in clear I think so..
Patient given thiamine because
Thiamine is prescribed to prevent Wernicke encephalopathy a acute disorder due to thiamine deficiency manifested by confusion, ataxia, ophthalmoplegia and Korsakoff's syndrome, which is manifested by memory impairment and amnesia .In-adequate dietary intake, Reduced gastro intestinal absorption on consumption of alcohol ,Decrease hepatic storage ,impaired utilization.
10)https://pranaykumar32.blogspot.com/ 👇
💥what is finger escape?
I don't agree with answer ,no proper definition and picturing...
Some what better definition of finger escape Presence of weak finger adduction in cervical myelopathy is called - FINGER ESCAPE SIGN
Question-2...
✊https://www.blogger.com/u/2/blog/post/edit/1620371337694272699/7292980154512361250
Question-3 and 4💭💭
https://61tejarshini.blogspot.com/2021/06/general-medicine-case-discussion.html?m=1
👉 Case is well done, with all appropriate matter...
Mentioned everything related to case history taking that is... Chief complaint, history of present illness, history of past illness, personal history, family history, general examination, systemic examination are done. Every thing is perfectly done along with inserting pictures of patient and reports of other investigations .Clear information about the treatment done each day until the patient discharged.
Patient came with the complaint of altered sensorium, he has shortness of breath, lethargy, anasarca.
Before for neck pain and lower back pain he has taken creatinine.
I have explained about creatinine action :-
💦Creatinine --Creatinine levels are usually an indication of normal muscle metabolism. It usually enters your blood after it is broken down. Your kidneys then remove it from your bloodstream before creatinine finally exits your body through urine.
He used to have chronic kidney disease -treatment taken and hypertension -on medication some details about it's actions:-
💦T STAMALOBETA OD--Tablet is a combination medicine that contains two active ingredients, Amlodipine and Atenolol Both of medicines in this combination work to lower blood pressure but in different ways. Together they help to relax the blood vessels, reduce the heart rate.
Finally ,he was in treatment in hospital
Given ,I have know it's action as follows
💦INJ.LASIX(40mg/IV/TID)-- A diuretic . It helps your body get rid of extra water by increasing the amount of urine you make. Getting rid of extra water decreases the strain on your heart and blood vessels, thereby lowering high blood pressure and reducing your risk of strokes, heart attacks and kidney problems. This effect can also improve symptoms such as trouble breathing and edema.
💦J.NaHCO3(100meq in100mlNS/IV/Stat)--this is the article about it... More information in it..
https://www.statpearls.com/articlelibrary/viewarticle/29196
💦T.NODOSIS 550mg/P.O/TID-- Tablet relieves irritation by producing carbon dioxide which neutralizes the acid present in the stomach. It also increases the pH of blood and urine, thereby correcting acid indigestion, heartburn. Additionally, it helps in the removal of toxic substances from the body in certain types of poisoning.
Question-5👊
Reflective logging of my experiences is a vital tool toward competency development in medical education and research.
💨we have started our clinical class and have been briefed about the case history taking and many cases for referral...it is very useful to us..
It helps us to see different cases how they are treated ,drug usage ,how to diagnosis the case and prevention too..
Clinical posting classes would be better understood and well exposed if we are in college ..due to pandemic we are having online classes where our seniors and HOD sir are doing a great job to make us understandable, to involve in the cases ,to answer the questions ..if not known, searching and find out the answer.. exposing them in group these type of many things happening...to upgrade us in competency medical education and research.
This type of learning makes our work easier and perfect ..
Exposure to multiple cases in these type of education creates a research abilities in students..
As we know present situation of COVID ..mortality rate has been increased...to prevent it many people are trying for past months...
By this type of learning from the beginning of medical life...in future ..we would be in that place of preventing any type of disease ..Hoping so..
AT LAST THANK U SIR...FOR GIVING THIS TYPE OF WORK...I HAD FACED IT FIRST TIME . I LEARENED MANY THINHGS FROM THIS ASSESSMENT...
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