Bimonthly assignment june 2021

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BIMONTHLY ASSIGNMENT OF MEDICINE FOR JUNE 2021

QUESTION 1:

  https://medicinedepartment.blogspot.com/2021/06/medicine-department-paper-for-june-2021.html?m=1

1) PULMONOLOGY

PATIENT DETAILS :

https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html

REVIEWS FOR THE LINK :

http://haqansariblogformonthlyassiggnment.blogspot.com/2021/06/questions-1-what-is-evolution-of.html

  1. Reason for patient's SOB is explained properly i.e., due to pollen and dust from paddy fields. Anatomically it is localized to lower air ways[from CT Finding] and etiology lies in the fact that patient had been chronically  exposed to lung irritants
  2. even in my view placebo cannot relive any of patients discomfort and I agree with chest physiotherapy ,head end elevation , BiPaP-augmented lung expansion. MEDICATION; azithromycin ,lasix ,nebulization with budecort 
  3. reasons for her exacerbation are true because  she  is continuously exposed to allergens[paddy and pollen] , also due to viruses like rhinovirus , influenza , pnemococcus 
  4. NO, Anti tubercular drug treatment did not affect her symptoms 
  5. yes, drug induced hyponatremia i.e., telmisartan could have caused electrolyte imbalance 


2) NEUROLOGY

PATIENT DETAILS :

https://143vibhahegde.blogspot.com/2021/05/wernickes-encephalopathy.html

REVIEWS FOR THE LINK :

 https://mdparvezahmedansari.blogspot.com/2021/06/medicine-blended-assignment.html

  1. Etiology is stated accurately i.e., alcohol withdrawal and symptomatology stands the same [seizures, tremors, restlessness]
  2.  Thiamine, lorazepam, Kcl are standard medication in my view
  3. Alcohol withdrawal symptoms will fit the best
  4. It is right decision to give thiamine since it is majorly involved in ATP and NADH production 
  5. dehydration is the only probable cause for dehydration in my view
  6. The mentioned reason is appropriate i.e., alcohol decreases iron absorption and bleeding ulcer is cause for normocytic anaemia
  7. yes aggrevated ulcer is due to both combined effect of diabetes and peripheral neuropathy

3) CARDIOLOGY

PATIENT DETAILS :

https://muskaangoyal.blogspot.com/2021/05/a-78year-old-male-with-shortness-of.html.

REVIEW FOR THE LINK :

https://meesumabbas82.blogspot.com/2021/05/case-opinions-may-2021.html

  1. differences between heart failure with preserved ejection fraction and with reduced ejection fraction are explained in detail. causes for Heart failure with reduced ejection fraction are also mentioned
  2. decision for not performing an unnecessary procedure [pericardiocentesis] was wiser
  3. list of risk factors for heart failure given stand true here 
  4. several causes for hypotension are mentioned 


4) GASTROENTEROLOGY(& PULMONOLOGY)

PATIENT DETAILS :


 REVIEW FOR THE LINK :

https://sofiajabeen1912.blogspot.com/2021/05/pulmonogy-1.html
  1. Time line of symptomatology is illustrated briefly in a photograph
  2. Efficacy and mechanisms of drugs is explained in brief  

5) NEPHROLOGY

PATIENT DETAILS :


REVIEW FOR THE LINK :

  1. Cause for SOB is correct (i.e., due to usage of diuretics) 
  2. The cause for drowsiness is effectively illustrated in a photograph
  3. Plenty of pus cells in his urine passage appeared as fleshy mass like passage ,there could be parenchyamal damage is the proper explanation
  4. Information about complications of TURP are very helpful

6) INFECTIOUS DISEASE (HI VIRUS, MYCOBACTERIA,GASTROENTEROLOGY, PULMONOLOGY)

PATIENT DETAILS :


REVIEW FOR THE LINK :

  1. The clinical symptoms choosed will exactly diagnose trachea esophageal fistula
  2. Prevention methods adviced are best suited

7) INFECTIOUS DISEASE AND HEPATOLOGY 

PATIENT DETAILS :


REVIEW FOR THE LINK :

https://muskaangoyal.blogspot.com/2021/05/bimonthly-clinical-case-assignment-1.html
  1. Adverse effects of consuming locally made alcohol are explained
  2.  Etiopathogenesis  of liver abscess in a chronic alcoholic patient is illustrated
  3. Probability of Liver abscess in its lobes is demonstrated

8) INFECTIOUS DISEASE (MUCORMYCOSIS, OPHTHALMOLOGY, OTORHINOLARYNGOLOGY, NEUROLOGY) 
 
PATIENT DETAILS :

http://manikaraovinay.blogspot.com/2021/05/50male-came-in-altered-sensorium.html

REVIEW FOR THE LINK :

  1. Symptomatology are described briefly event wise according to the following dates
  2. Mechanism and Efficacy is properly illustrated in photograph sequentially
  3. Explained the reason for sudden raise in mucormycosis in India

9) INFECTIOUS DISEASE (COVID-19)

PATIENT DETAILS 

https://nikhilasampathkumar.blogspot.com/2021/05/covid-pneumonia-in-pre-existing-case-of.html

REVIEW FOR THE LINK :

https://meesumabbas82.blogspot.com/2021/05/case-opinions-may-2021.html
  1. Explained about Importance of ILD in prognosis of COVID Patients
  2. Provided reference link to study about effects of using steroids in COVID patients (https://www.health.harvard.edu/blog/does-lupus-or-arthritis-affect-your-prognosis-if-you-get-covid-19-2020110921230#:~:text=There%20was%20some%20good%20news,prognosis%20for%20the%20arthritis%20patients.)
  3. Role of auto immune response in COVID Patients (https://www.healio.com/news/rheumatology/20210329/covid19-more-severe-than-influenza-in-patients-with-autoimmune-disease)

10) MEDICAL EDUCATION
   
  This experience of blogging medicine cases and giving out case opinions and answers to all other patient related questions has been very illuminating and definitely an innovative approach to learning during this pandemic in my opinion.

QUESTION 2:

https://mohammedwahaaj11.blogspot.com/2021/07/a-55yr-old-male-withanasarca-secondary.html

QUESTION 3&4

https://pallavi191.blogspot.com/2021/06/gm-cases.html?m=1

    Patient fell down suddenly followed by weakness of lower limbs, lost his grip in hand , and also suffered with bowel and bladder incontinence - attendents brought him to OPD after 10 days of his fall.
     He is a known case for TB and i on ATT medication. Patient had already developed weakness since 15 days back.-- as he has paraplegia , weakness my first thought process to approach this case is to start with neurological anaemolies and his bladder and bowel incontinence (loss of control over smooth muscle) will also indicate about any sort of lesions with in CNS

   REASONS FOR PERFORMING TESTS:
  1. ECG: as the patient was hypertensive since 5 years, by doing an ECG we can rule out any cardiac complications that may have exaggerated 
  2. BLOOD UREA, CREATININE, SERUM ELECTROLYTES: patient is on ATT so there is side effect of these drugs which may cause renal failure, therefore we can rule out any kidney related complication
  3. COMPLETE BLOOD PICTURE: based on the count of cell we can rule out or can guess if there is any infection 
  4. CHEST X-RAY: To check for any presence of cardiomegaly
  5. MRI BRAIN WITH CERVICAL SPINE: report have shown the site of lesion 
  From above all investigations it was diagnosed as:
  • Quadreparesis secondary to infectious spondylitis of C4, C5, C6, C7 and D1 with Epidural abscess at C5 - C6 level.

  TREATMENT: 
  1.  Inj. Optineuron 1Amp in 100ml NS  IV/OD - is given to subside his neurological manifestations
  2. ATT - according to body weight 2 tab PO/OD -  for his TB
  3. Thiamine - is given to boost his immune system to fight against infectious spondylitis and also for treating some of his neurological problems

QUESTION 5:

     This month’s logging and learning was one on the most astounding things I have done this year. This has enabled a pathway for me to learn and understand in even more innovative ways. 
     During this time, I have had a virtual clinical exposure along with online lectures where I learned the basics of patient care such as history taking, general and systemic examination. 
    Along with this, I also read through several medical blogs of various systemic disorders which helped me understand several pathological changes that occurred in contrast to the physiological mechanisms that I had learned last year. Something new that I learned with this was various investigations that are to be performed with specific signs and symptoms and differentials that can be drawn from them. 
      Besides this, we also reviewed the blogs which was a wholesome approach to learning about how to assess and evaluate an answer while comparing it to a standardized one. This also paved a path for me to get into research and understand the latest advancements and breakthroughs that have occurred in various fields. 
      I learned how to blog which is definitely a prized possession for me. I will keep nurturing and expanding these blogging that I’ve had and would love to indulge in such activities in the future too. 
      I would like to thank Dr. Rakesh sir for providing me an opportunity to be able to create blogs and knowing about the patients complications in detail. I would also like to thank Dr. Rishik sir for guiding me to be able to cope up with the subject even during this pandemic.






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