GENERAL MEDICINE ASSIGNMENT -2021
Hi, I'm Tejaswi enduri, a medical student (3rd sem).
Q1) QUESTION 1
This is a peer review of the previous assignment by JAGADEESH ( 37 )
https://gouthajagadeesh37.blogspot.com/
Q)1
He did a very impressive work did a thorough review of all the 10 cases that he selected. He not only gave an insight but have a brief review on the whole case as well. He managed to take different cases and also added pictures and needed info under each case link.
Q)2
He did not come up with any case yet.
Q)3 and 4
He took a case of heart failure due to left ventricular dysfunction.
A 70-year-old patient presented with a distended abdomen and shortness of breath.
https://60shirisha.blogspot.com/
Reviewed by - https://gouthajagadeesh37.blogspot.com/2021/07/nameg.html
He gave a brief overview of the condition and investigations done and treatment that was given. He also supported his statements with the reports of investigations.
Also, he suggested and kept his forward stating if thyronorm was used think she would have not passed away.
https://gouthajagadeesh37.blogspot.com/2021/07/nameg.html
Q) 5
He gave a genuine review and his honest feeling.
Q) Question 2
It is a case of transverse myelitis. patient presented with pain in epigastrium and pain on passive movement sideways, not able to move the legs and absence of sensations below the umbilicus .http://tejaswienduri.Blogspot.com/2021/07/36-tejaswi-enduri.Html
Upon investigating the MRI inflammation is seen in the spinal cords and classical features of transverse myelitis were presented.
Q)3
1) AKI
https://laharikantoju.blogspot.com/2021/07/58-year-old-male-patient-elog-lahari.html?m=1
A patient with acute kidney injury
The patient presented due to abdominal pain and lower back after an injury while weightlifting D
Diagnosed as AKI secondary to UTI
insights
The blog is not soo clear. The conclusion of how they got to a conclusion AKI with UTI could be explained more clearly. How was the lower back pain ruled out is also not explained.
2) Acute on CKD
http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html
The patient presented with lower back pain and dribbling of urine for 10 days .he also had bilateral pedal edema and shortness of breath.
He was diagnosed with acute renal failure associated with multifocal spondylitis.
insights
The blog is very impressive all the symptoms like the cause of seizures and delirium are explained and day-wise treatment update.
3)
CKD
https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1
49 yr old female with generalized weakness and vomiting .she was operated on previously for hemorrhoids and was on NSAIDs
She was diagnosed with chronic interstitial nephritis secondary to plasma cell dyscrasias ( multiple myeloma - 70 % plasmacytosis ).
insights
The case was comprehensive and concise and we'll be excreted. All the necessary information was provided and even the investigation with reports and histology slides of the plasma cells was also uploaded.
4)acute renal failure with lower back pain
casereports.bmj.com/content/2009/bcr.03.2009.1726
A 47 yr old man presented with uremic symptoms and oliguria, lower back pain, and altered sensorium .renal biopsy showed moderate tubulointerstitial nephritis with mild global glomerular sclerosis.
Altered sensorium was because of uremic encephalopathy .lower back pain due to osteolytic lesions due to plasma cell dyscrasias.
The bone marrow findings are suggestive of Waldenstrom’s macroglobulinemia (WM).
insights
The blog is exceptionally done explaining each symptom and gradually diagnosis and treatment. The case scenario and complaints were explained in detail with duration.
5) patient with coma and renal failure
https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html
A 35 yr old female presented with chest pain abdominal pain, diarrheal with bloody discharge, shortness of breath, she was a known case of diabetes.
She also had bedsores and usg showed pyelonephritis
The patient was comatose and put on a mechanical ventilator but she gradually miraculously recovers.
Diagnosed as AKI secondary to diabetic ketoacidosis.
insights
The case is very well done, history and complaints were chronologically taken .it is very detailed and day-wise investigations treatment and even images are uploaded of every investigation done.
6) patient with coma and renal failure
https://pallavi191.blogspot.com/2021/06/gm-cases_30.html?m=1
52 yr old presented with chief complaints of abdominal distension, constipation, pedal edema, hiccups since morning .he is a known case of diabetes. he was an alcoholic
The patient is diagnosed and infective endocarditis wait AKI assisted with alcoholic liver disease with multiple infarcts in the bilateral cerebral and cerebellar regions.
Might be septic or uremic or diabetic encephalopathy.
insights
The case is well explained with pictorial depictions, and the vedioes of 2 d echoes were also provided. A detailed treatment plan is given.
7) patinets on acute in CKD
https://kavyasamudrala.blogspot.com/2021/05/medicine-case-discussion-this-is-online.html?m=1
52 yr old man presented with fever and pus in the urine. He is a known case of diabetes mellitus type 2.
He had suffered from Burning micturition which was due to prostomegaly and was corrected by a surgery TURP.
But complications developed do it and the patient reported generalized weakness and decreased appetite, drowsiness, SOB respectively on his consecutive visits.
The diagnosis was renal AKI secondary to urosepsis secondary to b/l hydroureterosepsis.
Diabetic nephropathy was secondary to CKD.
insights
The log was exceptionally done .it is clear and precise. Comparisons between before and after treatment were done and the diagnosis was made clear.
8)
https://rishikakolotimedlog.blogspot.com/2021/07/45-year-old-male-with-chief-complains.html?m=1
48 yr old man with SOB .he is a known case of HT and DM.2 yrs back diagnosed with chronic renal failure .he also had issues of orthopnea and bend opener in the past.
Pedal edema present.
Diagnosis-HFrEF secondary to CAD, CRF
insights
The case is comprehensive and well presented .consise research was done and even links of very such cases were presented.
9)
https://krupalatha54.blogspot.com/2021/06/this-is-online-e-log-book-to-discuss.html?m=1
60 yr old female with anasarca and SOB.complaints of pedal edema and decreased urinary output .she has 10-15 episodes of an SOB in a yr.
She is having cor pulmonale. Might have suffered uremic nephropathy.
insights
The case was not so clear as there were many assumptions in the condition and the patient was symptomatically treated.
10)
https://keerthireddy42.blogspot.com/2021/07/43-yr-old-male-of-nalgonda-came-to.html?m=1
Alcoholic hepatitis and AKI secondary to gastroenteritis
A 43 yr old man presented with chief complaints of loose stools, edema, and abdominal distension
insights
The case is done precisely with chronological history and day-wise observations and treatment. the case is clear and pictorially assisted well.
11)
https://casescape.blogspot.com/2021/06/acute-kidney-injury-secondary-to.html?m=1
Acute kidney injury secondary to urosepsis
A 60 yr old female with decreased urinary output, pedal edema, burning micturition, and fever. Happened before as well treated with dialysis.
insights
The case is very clearly presented. It is well explained and understandable. all the necessary information is given, like the investigation, reports, symptoms, pics, treatment.
12)
http://chavvaclassworkdecjan.blogspot.com/2021/06/pancreatitis-in-chronic-alcoholic-with.html?m=1
Pancreatitis in a chronic alcoholic with AKI
A 31 yr male was presented with pain in the abdomen, SOB, and vomiting. hard liquor, and tahini addict. diagnosis as acute pancreatitis with AKI and b/l pleural effusion.
insights
The log was clear and precise. the case summary has been provided which helps in easier understanding.
Q)4
1)
Diagnosis
Acute kidney injury( AKI) 2° to UTI,
Treatment
1)IVF : -RL @ UO+ 30ml/hr
2)SALT RESTRICTION < 2.4gm/day
3)INJ TAZAR 2.25gm IV/ TID
4)INJ PAN TOP 40mg IV/OD
5)INJ THIAMINE 1AMP IN 100ml NS IV/TID
6)TAB. PCM 500mg PO/ SOS
7)INJ HAI S/C ACC TO SLIDING SCALE
8)INFORM GRBS
9)GRBS - 6th Hourly
10) BP/PR/TEMP - 4th Hourly
11) I/O - CHARTING (STRICT)
12)T. ULTRACET PO 1/2 TAB QID
Diagnosis-
Treatment
3)
Diagnosis
Treatment
Diagnosis-
Treatment
Diagnosis-
Treatment
Diagnosis
Treatment
Diagnosis
Treatment
1. TAB. BISOPROLOL 5mg OD
2.TAB. NITROHART 20/37.5mg 1/2 T/D
3.TAB NICARDIA XL 30mg OD
4.TAB. GLICIAZIDE 80mg BD
5.TAB. NODOSIS 500 mg TD
6.Cap. BIO-D3 OD
7.Cap. GASOLINE OD
8.TAB. ecosprin-AV 150/20mg OD
9.TAB.LASIX 40mg BD
10. SYP. LACTULOSE 15ml
Diagnosis
Treatment:-
Diagnosis
Treatment
- INJ THIAMINE 100 mg in 100 ml NS slow IV / TID
- INJ OPTINEURON 1AMP in 100 ml NS slow IV / OD
- INJ LASIX 40 mg
- TAB. ALDACTONE 50 mg PO / BD
- INJ PAN TOP 40 mg IV/ OD
- ABDOMINAL GIRTH MEASUREMENT DAILY
- BP /PR/TEMP/ RR -4 hourly
- I/O CHARTING
Diagnosis -
- Acute kidney injury secondary to urosepsis
Treatment
- Inj LASIX 40 mg IV/TID 1 -1 - 1
- IVF - NS @ UO + 50 ml/hr
- Inj MAGNEXFORTE 1.5 gm/IV/BD
- Tab NODOSIS - 500 mg PO/OD
- Tab OROFEA - XT PO/OD
- Inj HAI s/c
- Neb plain Asthalin 2 respules QID
- Strict I/O charting
- Tab ULTRACET 1/2 tab QID[ 1/2 - 1/2 - 1/2 - 1/2 ]
Diagnosis -
with ?B/L pleural effusion and moderate ascites.
Currently in ? Alcohol withdrawal.
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