FORMATIVE ASSESSMENT

Medicine paper for July 2021 bimonthly blended assessment

NAME:JASMISRI

ROLL NO :91

3RD SEM

                                                                                                                                                                                                                                                                                 

Below link has given assessment questions:-

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

QUESTION-1

**Peer review of each answer given by my friend Sneha Rollno.91 in last month bimonthly assessment👇

http://medicinedepartment.blogspot.com/2021/07/2019-batch-medicine-department-online.html?m=1

Now lets see review of  each question,

• Question-1-
• As asked she has given peer review for the  answers given by our seniors by taking ten different roll no's and she mentioned the what type of case it is and for respective case related  answer she given appropriate, well and good review but review is simple in short words. I agree with her presentation.

• Question-2-
• It was so unhappy that she didn't get the opportunity to present a  E log.

• Question-3&4-
• She has mentioned patient context followed by positives and negativities  of case presented by our seniors. I agree with her answer because it presented in a different way and simplified manner. I think it would be very perfect if she elaborated about treatment and diagnostic details.

• Question-5-
• she has given only few points but they are good it would more better if she expressed more things. 

QUESTION-2

Sir, this month I have been not allotted a case by seniors to prepare a E log.

QUESTION-3

**Critical appraisal of the captured data

Patients with low back ache and renal failure:-

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

About completeness and correctness, every thing is mentioned and data is collected nicely, detailed history is taken and examination is mentioned well, investigations are done for six days it is proper with photos and radiographs but patient details are appearing. And provided  only some useful leads to analyze the diagnostic and therapeutic uncertainties.

(2)http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html

About completeness and correctness, detailed history, examination, investigations with respective data in photos, And provided useful leads to analyze the diagnostic and therapeutic uncertainties, treatment given for 7 days is mentioned properly.

(3)https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1 

About completeness and correctness, history is not in proper pattern and examination is ok  and Investigations related report photos and histology images are linked to E log it is good, treatment given daily is nicely mentioned.

Patient with coma and renal failure:

(4)https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html

About completeness and correctness, History taken is not presented properly, examination is good with echo report, investigations are well and good with reports and patient diseased site photos are attached and daily treatment is clearly mentioned in E log. And provided useful leads to analyze the diagnostic and therapeutic uncertainties.

(5)https://pallavi191.blogspot.com/2021/06/gm-cases_30.html?m=1

About completeness and correctness, Detailed history is taken, examination with photo showing edema, investigations with appropriate report along with echo photos and videos, detailed treatment given for days. And provided useful leads to analyze the diagnostic and therapeutic uncertainties. Overall E log is well and good.

Patients with acute on CKD:

(6)https://kavyasamudrala.blogspot.com/2021/05/medicine-case-discussion-this-is-online.html?m=1  

About completeness and correctness, history taken is detailed but I think it would be nice if presented in the form of points. Examination is detailed, investigations with reports and radiographs and urine color is shown. And provided useful leads to analyze the diagnostic and therapeutic uncertainties.

(7)https://rishikakolotimedlog.blogspot.com/2021/07/45-year-old-male-with-chief-complains.html?m=1

About completeness and correctness, history is detailed in chronological order, examination, investigations with reports, treatment is mentioned. some important things are highlighted which makes easier leads to analyze the diagnostic and therapeutic uncertainties.

(8)https://krupalatha54.blogspot.com/2021/06/this-is-online-e-log-book-to-discuss.html?m=1

About completeness and correctness, Here every thing is complete with appropriate photos of examination and investigations reports, radiographs but presentation of E log  is without proper heading. 

Patients with AKI :

(9)https://keerthireddy42.blogspot.com/2021/07/43-yr-old-male-of-nalgonda-came-to.html?m=1

About completeness and correctness, History is detailed, examination with photos better understandable, investigations with appropriate reports and radiographs, treatment details for 7 days. Therefore, provided useful leads to analyze the diagnostic and therapeutic uncertainties.

(10)https://casescape.blogspot.com/2021/06/acute-kidney-injury-secondary-to.html?m=1

About completeness and correctness, History is detailed, examination is well done, investigations done details and reports for 6 days,  treatment details for 10 days, detailed information day by day provide leads to analyze the diagnostic and therapeutic uncertainties.

(11)http://chavvaclassworkdecjan.blogspot.com/2021/06/pancreatitis-in-chronic-alcoholic-with.html?m=1

About completeness and correctness, History is taken in detail  and in complete but  I think there is no proper presentation in the form of points. Examination, investigations with reports for days and treatment details are mentioned.

QUESTION-4 

**Problem list for each patient and the diagnostic and therapeutic uncertainty around solving those problems as follows:-

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

ACUTE KIDNEY FAILURE

A 58 year old male patient came to casualty with  chief complaints of lower abdominal pain, burning micturition, low back ache after lifting weights, dribbling of urine, fever, SOB at rest

• Alcoholic
• Loss of appetite, Irregular bowels, abnormal micturition
• BP : 140/70mmHg, PR : 88bpm, SPO2 : 95% at room air
• Tenderness present(in supra public pain RIF), IVP increased.

1. TAZAR 4.5g Injection is a combination of two antibiotics. It is used to treat various types of  bacterial infections. It fights against the infection by killing the microorganisms. 
2. PANTOP  injection:-Is also used to prevent stress ulcers in seriously ill patients and is administered before anesthetic medication to help prevent aspiration-related complication.
3. Thiamine is a B vitamin that helps your body to use carbohydrates for energy. It is also important for normal function of your heart, muscles, and nervous system.
4. Human ACTRAPID 40IU/ml Solution for Injection is a short-acting type of insulin that is usually used along with other diabetes medication for controlling blood sugar levels. 
5. LACTULOSE USES:- It is primarily used to treat constipation.

(2)http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.h

ACUTE ON CHRONIC KIDNEY DISEASE

  A 75yr old male patient, came with Chief complaints of Lower backache, dribbling of urine, Pedal edema, SOB at rest, Increased involuntary movements of both upper limbs.

• Jaundice 3yrs back which is relieved on plant based treatment.
• Dyspnea Grade 

1. Inj. TAZAR 2.25gm I.V 
2. PANTOP INJ
3. Lasix is used to treat fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder
4. Salbutamol NEBULIZER Solution is indicated for use in the routine management of chronic bronchospasm unresponsive to conventional therapy and the treatment of acute severe asthma.
5. PCM Tablet is an analgesic (pain reliever) and anti-pyretic (fever reducer). It works by blocking the release of certain chemical messengers that cause pain and fever.
6. The Foley catheter is a sterile, thin tube that is placed within the bladder in a process known as catheterization. The Foley catheter is used as a means of draining urine without the need for urination.
7. Inj. PIPTAZ 2.25gm -I.V -TID combination medicine used to treat a variety of conditions such as urinary tract infections, lower respiratory tract infections, intra-abdominal infections, skin and skin structure infections, etc. caused by susceptible bacteria.
8. SYP  MUCAINE gel 10ml -BD used to treat and prevent ulcers in the intestine.

(3)https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1

CHRONIC KIDNEY DISEASE

49 yr old female  came asymptomatic noticed mass per anum with bleeding

• Fever, generalized weakness, vomiting
• Usage of NSAIDS
• Loss of appetite
• Restricted movement in right wrist joint, pallor, scaphoid abdomen on examination.

1.  T. PAN 40mg  is an anti-ulcer medicine used to treat conditions where the stomach produces too much acid.
2.  T. ZOFER 4mgis used for nausea or vomiting. 
3. TAB NODOSIS f 550 mg  for indigestion.
4.  T. OROFER - XT control and prevention of different types of anemia.

(4)https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html

DIABETES KETOACIDOSIS WITH AKI

35 yr old female came with a chief complaint of fever, diarrhea, back pain, abdominal pain, chest pain.

• Type 2 diabetes mellites
• Altered sensorium
• Pallor on examination
• Bed sores                                                                                                                                   

1. Inj. NORAD 2amp in 50ml NS NORAD 2mg Injection is used to normalize decreased blood pressure (hypotension) which may occur all of a sudden during an operation, severe infection (sepsis) or due to an emergency condition (cardiac arrest).
2. Inj. PIPTAZ 2.25gm.
3. Inj. DOPAMINE 2amp
4. Inj. HAI 1ml 
5. Inj. CLEXANE 40gm. is an anticoagulant which is used to prevent the blood clots in the legs. It is used in combination with warfarin to treat blood clots. 

(5)https://pallavi191.blogspot.com/2021/06/gm-cases_30.html?m=1

INFECTIVE ENDOCARDITIS WITH AKI

52 yr old male came with a chief complaint of abdominal distention.

• Type 2 diabetes mellites
• Icterus and pedal edema on examination 
• Ejection systolic murmur heard in all areas radiating to carotid
• Infective endocarditis

1. Inj. MONOCEF 1gm  is used to treat bacterial infection 
2. Inj. Vancomycin 500mg bactericidal antibiotic 
3. Inj. Augmentin 1.2 gm is used to treat infections
4. Tab. ECOSPIRIN 150mg It is used as an anti-inflammatory and analgesic which can relieve pain and swelling, It is used to bring down high body temperatures and to prevent recurrence of heart attacks or strokes by thinning the blood, It reduces the risk of a blood clot occurring in the heart or brain.
5. Tab. CLOPIDOGREL75mg is used to reduce atherosclerotic event.
6. Tab. ATORVAS 20mg  Lowering the amount of cholesterol reduces the chances of heart diseases and helps you remain healthier for longer.

(6)https://kavyasamudrala.blogspot.com/2021/05/medicine-case-discussion-this-is-online.html?m=1  

AKI SECONDARY TO UROSEPSIS

52 yr old male came with a chief complaint of fever and pus in urine.

• Diabetes mellitus, transurethral resection of prostrate
• Addiction to alcohol

1. Injection OPTINEURON 1AMP is used to cure nutritional deficiency or Vitamin B12 deficiency, anemia and hemorrhage. It also helps in blood formation, cell and tissue reproduction and growth. This drug can be consumed as an over the counter medicine
2. Injection NEOMOL 100ml IV  used to treat Fever and Pain.

(7)https://rishikakolotimedlog.blogspot.com/2021/07/45-year-old-male-with-chief-complains.html?m=1

CHRONIC RENAL FAILURE

48 yr old male came  to OPD with a chief complaints of SOB. 

• HFrEF secondary to coronary artery disease.
• Chronic renal failure, chest pain
• Diabetes mellites, hypertension
• Bowel movements irregular, addiction to alcohol
• Edema, dyspnea on examination

1. TAB. BISOPROLOL 5mg Bisoprolol is used with or without other medications to treat high blood pressure ( hypertension ). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. This medication belongs to a class of drugs known as beta blockers.
2. TAB. NITROHART  is used in the treatment of heart failure. It is a combination of two medicines that effectively controls symptoms of heart failure.
3. TAB NICARDIA XL  It is a calcium channel blockers. It works by relaxing blood vessels so that blood can flow more easily around your body. This means that more oxygen gets to your heart and reduces the risk of getting chest pain (angina).
4. TAB. GLICIAZIDE treatment of type 2 diabetes
5. Cap. GEMSOLINE For treatment and prevention of vitamin D and calcium deficiency.

(8)https://krupalatha54.blogspot.com/2021/06/this-is-online-e-log-book-to-discuss.html?m=1

PNEUMONITIS AND ACUTE ON CKD

60 yr old female patient came with chief complaints of pedal edema, decreased urine output, loose stools, vomiting.

• Seasonal SOB using inhalers 
• Pneumonitis. 
• Ejection systolic murmur heard in all areas (aortic, pulmonary, tricuspid and mitral areas) radiating to carotids.

1. Tab. Pan 40 mg  
2. Inj. Lasix 80 mg IV 
3. Thiamin 200 mg 
4. Tab. LEVOCET 5 mg  
   For relieving seasonal allergies, common cold, runny nose and sneezing. 
   It also helps in reducing swelling and itching due to skin allergies and insect bites

(9)https://keerthireddy42.blogspot.com/2021/07/43-yr-old-male-of-nalgonda-came-to.html?m=1

ALCHOHOLIC HEPATITIS AND AKI

43 yr old male came with chief complaints of abdominal distention, loose stools, pedal edema.

• Jaundice and TB
• Addicted to alcohol
• Pallor, distended veins on examination.

 

1. INJ THIAMINE 100 mg in 100 ml NS slow IV / TID
2. INJ OPTINEURON 1AMP in 100 ml NS slow IV / OD
3. INJ LASIX 40 mg
4. TAB. ALDACTONE known as a diuretic (water pill). It is mainly used in the treatment of heart failure and high blood pressure. It is also used to reduce swelling (edema)
5. INJ.METROGYL  is used to treat certain infections caused by bacteria 
6. INJ .CIPROFLOX to treat bacterial infections.

(10)https://casescape.blogspot.com/2021/06/acute-kidney-injury-secondary-to.html?m=1

AKI SECONDARY TO UROSEPSIS

60 yr old female with chief complaints of pedal edema, decreased urine output with burning micturition and fever. 

• Type 2 diabetes mellitus
• Pallor on examination

1. INJ LASIX 40 mg 
2.  Tab NODOSIS - XT  
3. INJ MAGNEXFORTE 1.5 gm It is used for treating Pseudomonas bacteria l infections which are otherwise resistant to this group of antibiotics 
4. Tab OROFEA -for the treatment of anemia, iron deficiencies, megaloblastic anemia caused due to lack of folic acid, poor diet, poor absorption of food and folate deficiency. 

(11)http://chavvaclassworkdecjan.blogspot.com/2021/06/pancreatitis-in-chronic-alcoholic-with.html?m=1

ACUTE PANCREATITIS WITH AKI

31 yr male farmer came with a chief complaint of pain in abdomen, vomiting, SOB

• Addictions-hard liquor and khaini
• Pedal edema is present
• Distended abdomen, tenderness in epigastric and hypogastric regions. 

1. IV LASIX  40 mg
2. Tab NODOSIS 
3. IV PIPTAZ 4.5  
4. Iv 25%Dextrose 100 ml 
5. Tab . NICARDIA 10 mg which has Nifedipine as an active ingredient present in it. This medicine performs its action by decreasing the blood pressure in the body

QUESTION-5

**Logging reflective observations on my concrete experiences of this last month ..

• Clinical posting classes would be better understood and well exposed if we are in college.
• Now in the online sections of general medicine, In the guidance  of HOD sir:-By involving in the cases, by taking history of patient by calling to the attender to approach the patient in the ward and further details  such as investigation reports, radiographs photos, examination videos and photos, lot info related to the case given by our seniors.
• Then we are supposed to prepare a E log of respective patient with the details provided. 
• In this way our postings are going on... 
• Every month sir is allotting assessments through which our competency based development in medical education and research is improving by preparing the peer to peer review, reflecting the E logs, going through different cases.

THANK YOU SIR FOR ASSINING THIS TYPE OF ASSESSSMENT..