Beyond the blog 2

 General medicine blended assignment

Ch.janani 

Roll no. 29

Question 1

https://28chikatlalaharisha.blogspot.com/

I have chosen roll no. 28 laharisha. Her reviews are very good .she mostly did on pulmonology and some neurological cases.she had studied the case very well. In pulmonology case she hd understood about the causes of copd .specially she commented on vital features of the case.

In cardiology case she had commented that the terms in theaaanswers arevery confusing.

In neurology case it becomes easier for the diagnosis of the disease with all the symptoms and history taken by our seniors the evaluation of symptomatology is clearly described.the patient condition is summarized briefly history of present illness and past had been described  briefly and are easy to understand.she had commented on the history of the case  is very well presented with both general and systemic examination. The investigations are given according to the timeline.

She had learnt how to take the history of the patient,and importance os f history in the diagnosis and treatment of the disease. The list of the investigations are given clearly with the help of diagrams and pictures attached.the updated timeline with diagnosis are given  the provisional diagnosis is described very clearly.

Question 2

I didn't get a chance to do anything.

Question 3

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

In the above case the patient is asymptomatic since 2 yrs and had a non healing injury to the right foot which raised a suspicion of diabetes mellitus.

Complaints are tingling in upper limbs upto the palms and in lower limbs upto the knees.history of present illness past history and family history are taken. 

Before the consultation he is not known with hypertension, CAD,asthma,tb,epilesy.

No history of surgeries and blood transfusions in the past.

Presently he had icterus and pedal edema 

No pallor,cyanosis,clubbing and lymphadynopathy this is he's general examination.

Systemic examination is normal

Investigations are 

 

Many more investigations had been done and diagnosed as infective endocarditis with AV vegetation with moderateAS severe AR with AKI.

Treatment is given and the patient visited the hospital for maintenance hemodialysis..

 http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html
In this case history of present illness past history ,personal history,family history,general examination,systemic examination all are done which help to diagnose the disease easily 

Investigations include

All the investigations are done which are necessary for the diagnosis of disease.

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

In this case history is very clear which includes present,past,family,personal,obstetric history and menstrual history.

All the examinations are done with necessary investigations. 

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

This is the case to solve an attempt to understand the topic of patient analysis data .this helps us to develop competency in reading and comprehending  clinical data.

All the history,examinations and required investigations are done 

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

This is the case in which the examination pictures are also given clearly .

All the examinations ,history taking,investigations are very well done

Question 4

ACUTE KIDNEY DISEASES:

It is sudden in onset, primarily reversible. Generally, the patients come to OPD with c/o oliguria, lower abdominal pain, decrease in urine output with burning micturition, SOB, fever, vomitings- bilious, pedal edema in bilateral lower limb pitting type. It can be identified by serum creatinine levels O/e it shows low albumin levels, with normal hemoglobin concentration, not associated with anemia [rarely anemia can be noticed], normal lipid profile. Sometimes AKI are associated with other diseases like hepatomegaly, pancreatitis, CHF. Renal transplantation is not required, the patient should be on dialysis for a short period of time.

CHRONIC KIDNEY DISEASES:

It is sudden in onset, predominantly irreversible. General c/o of patients are muscle aches, fever, generalized weakness, vomitings- non-bilious, normal or increased urinary output [polyuria], no pedal edema [if associated with pedal edema there is periorbital edema too which indicates severe kidney damage], SOB- absent. O/e size of the kidney is reduced, hemoglobin concentration decreased, anemia is seen, marked changes in lipid profile [decreased HDL, increased LDL, TG]. Renal transplantation is necessary, dialysis- required repeatedly.

ACUTE ON CHRONIC KIDNEY DISEASE:

Sudden fall in GFR is diagnosed as acute kidney disease, nevertheless, some pt has pre-existing kidney injury leading to CKD.

Question 5

Since last month clinical postings had began in general medicine. This is very helpful to develop knowledge, skill,and attitude to treat common diseases at the primary care level.also helps to diagnose,workup  and proper referral of disease conditions .clinical teaching helps us to elicit a relevant and detailed history,and to carry out a physical examinnation,identify patient problems ,reach a differential diagnosis,formulate appropriate  investigations ,interprets the results of investigations ,to plan appropriate management and also to undertake some aspects of management.