GENERAL MEDICINE ASSIGNMENT - JULY 2021

                                  NAME-A.S.SIVARAM

                                               ROLL NO- 07

Below is the link of assignment given for us,

QUESTION (1)


Review to all the questions answered:

  1. She has done 10 cases,In each case she given a best review which was very helpful for us to understand the case details.
  2. She gone with good investigations and given a better explanation for every case and she followed steps in investigations.
  3. she gave grades for each case.
  4. She did nice but a little more explanation is needed which I felt except that everything was good.
My overall review about the cases she done is very nice.we get better understanding by studying the cases she mentioned.

QUESTION (2)


QUESTION 3:

CASE 1: AKI 

Here is the link given below for the case details:

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

She did thorough investigations and mentioned clear details about the case.It would be easy for analyzing the case. I would like to appreciate her regarding her case presentation and explanation.

CASE 2: Acute on CKD

Here is the link given below for the case:

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

The patient gone with many treatments by using different drugs to get relief. Every treatment that they gone was well written. finally they gone with diagnosis of acute renal failure. And I would like to appreciate her for the good explanation with the good picturization in the case.

CASE 3: CKD

Here is the link given below for case details:

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

The explanation about the case was very good and gone with detail investigations and finally got up with chronic interstitial nephritis secondary to plasma cell dyscariasis. investigations are very nicely gone to get probable diagnosis.

CASE 4: Patient with coma and renal failure

Below is the link for case that she explained:

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

The patient was facing type 2 diabetics 3 years ago and given some oral hypoglycemic agents with mistard injection.

CASE 5: Patient with coma and renal failure

Link for the case given below:

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

The case presentation was excellent and given good explanation, This is a complicated case as the patient facing many problems, present he got up with type 2 diabetics, the treatment given was very good, they got with the diagnosis of infective endocarditis with severe AKI which is a complicated problem.

CASE 6: Patient with acute on CKD 

Here is the link for the case:

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

The patient with post TURP with non oliguria ATN.

It is the case where pus is seen in the urine.

The patient has the history with transurethral resection of prostate gland.

Hydronephrosis is explained very nicely.

CASE 7: Patient with acute CKD.

Here is the link given for the case details:

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

Here is the patient with known Diabetics mellitus{DM} and Hypertension because of high BP .

This makes the patient to easy attraction for diseases.

the diagnosis is HFrEF secondary to CAD. 

LFT and RFT are quite abnormal.

CASE 8: Patient is acute on CKD 

Here is the link given below for the case:

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

The patient is with pedal oedema with decreased urine output and have history of SOB as the patient use the inhalers since 15 years. Patient also admitted with fever.

CASE 9: Patient with AKI

Here is the link given below for the case details:

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

The patient has dilated veins and distended abdomen.

bilateral pitting edema is seen up to knee. frequently consumption of alcohol caused alcoholic hepatitis.

CASE 10: Patient with AKI

Below is the details of the case presented:

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

⇨Here urosepsis is seen as there is infection of urinary tract.

⇒Generalized lymphadenopathy is seen.

The link given below is the info about the urosepsis:

https://www.ncbi.nlm.nih.gov/books/NBK482344/

CASE 11: Patient with AKI

Below is the link for the case:

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

The patient facing pancreatitis due to chronic alcoholism.

Investigations are done well for getting better understanding on the case.

Like ultrasound etc.

QUESTION 4:

✱Case 1
Diagnosis : AKI  secondary to UTI, associated with Denovo - DM -2 
Treatment : 
1)IVF : -RL  @ UO+ 30ml/hr -NS
2)SALT RESTRICTION  < 2.4gm/day
3)INJ    TAZAR    4.5gm  IV/TID
                                 |
                             2.25gm IV/ TID
4)INJ     PANTOP 40mg  IV/OD
5)INJ     THIAMINE  1AMP  IN  100ml   NS   IV/TID

✱Case 2
Diagnosis : Hyperuricemia 2° to Renal failure 
Treatment:
• IVF -    NS-0.9%  @100ml/hr
• Inj. Tazar 2.25gm I.V -TID 
• Inj. Lasik 40mg I.V -BD 

✱Case 3
Diagnosis:  Chronic interstitial nephritis secondary to plasma cell dyscariasis
Treatment:   
- T. PAN 40mg /PO / OD
- oral fluids up to 1.5 - 2 lit / day
- Protein - x ( plant based ) 2 tablespoon   in 1 glass of  milk  

✱Case 4 
Diagnosis: DKA with AKI 
Treatment:
Inj. NORAD 2amp in 50ml NS
Inj. PIPTAZ 2.25gm.
Inj. DOPAMINE 2amp in 50ml
Inj. HAI 1ml in 39ml NS

✱Case 5
Diagnosis:INFECTIVE ENDOCARDITIS
Treatment:
1. Inj. Monocef 1gm IV/BD
2. Inj. Vancomycin 500mg IV/BD in 100ml NS over 1hr
3. Procto clysis enema
4. Inj. Pan 40 mg Iv/OD

✱Case 6 
Diagnosis: Renal AKI secondary to urosepsis with b/L hydroureteronephrosis
Treatment: 
Injection PANTOP 40mg IV/OD
Injection PIPTAZ  4.5 stat  and 2.25 gm  IV/ TID
Injection LASIX 40mg IV/BD
Injection optineuron 1AMP in 100ml NS slow IV/OD

✱Case 7
Diagnosis: HFrEF secondary to CAD; CRF
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

✱Case 8
Diagnosis: Acute on CKD 
Treatment: 
1. Tab. Augmentin 625 mg ×7 days
2. Tab. Wysolone 40 mg ×10 days.
    30 mg × 10 days 
    20 mg ×10 days
    10 mg ×10 days.
3. Tab . Lasix 20 mg  × 1 month.

✱Case 9
Diagnosis: Alcoholic Hepatitis and aki sec to gastroenteritis
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  

     

✱Case 10
Diagnosis: Acute Kidney Injury secondary to Urosepsis
Treatment:
 Inj LASIX 40mg (8am- 2pm -8pm)
IVF - NS @ UO + 50 ml/hr

✱Case 11
Diagnosis: pancreatitis in a chronic alcoholic 
Treatment:
IV lasix  40 mg BD .
Tab Nodosis .
IV PIPTAZ 4.5 Gms. BD 
Iv 25%Dextrose. 100 ml BD 
Iv fluids : NS 40 ml /hr.

QUESTION 5:

The first thing I thank GM department for giving us such opportunity to make blog. the every log and and every case are very useful for us to understand and get a clarity on patient centered data and treatment for the patient. During this pandemic its highly impossible for us to know about clinicals. In that situation GM medicine department helped us a lot for understanding a case oriented details. They clearly explained about everything about how the patient will be, what should we do, what investigations should be done, everything they clearly explained. and now we can easily go for postings and we can easily grab the info from the patient and what to be done further, I got up with a good knowledge. Thank you for GM department.

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