GENERAL MEDICINE ASSESSMENT 3

          BIMONTHLY ASSESSMENT 

I am,M.easha chandrika,MBBS 3rd semester, holding roll no :76

QUESTION:1

https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006003-case-presentations.html?m=1

REVIEW:

Case:1

This is the case of ACUTE GLOMERULOPATHY (glomerulonephritis /nephrotic syndrome), Bilaterally Symmetric Chronic Progessive Inflammatory Peripheral Polyarthritis.

The features of the above Diagnosis include:

• Hypertension

• Haematuria

• Quantification of Proteinuria

• Serum Albumin

• Urine specific gravity

• Pain and Edema of joints

• Early morning Stiffness

• Systemic Inflammation

All the chief complaints of the patient, History and Investigations of the patient are thoroughly explained.

All the suitable Investigations were done which led to this diagnosis. 

The Diagnosis of the patient was very well explained.

The above elog was relevant in respective to the case with all the fine details.


Case 2:

This is the case of :

1. Idiopathic Parkinson's Disease Stage 1 with denovo HTN.

2. Multiple System Atrophy - Parkinsonian Type (MSA-P).

Investigations for the above case were ECG, 2D ECHO and Examination of CNS.

The treatment for the above case was were well explained which includes:

1. Tab. Syndopa Plus 125 mg QID

2. Tab. Syndopa 125 mg CR OD

3. Tab. Telma 40 mg OD

All the chief complaints of the patient, History and Investigations of the patient are thoroughly explained.

All the suitable Investigations were done which led to this diagnosis. 

The Diagnosis of the patient was very well explained.

The above elog was relevant in respective to the case with all the fine details.


Case 3:

The Diagnosis of the above case is:

 IATROGENIC CUSHINGS SYNDROME . 

TINEA CORPORIS .

DENOVO HTN .

Final Diagnosis of the above case was:

IATROGENIC CUSHINGS SYNDROME

SECONDARY TO TOPICAL CLOBETASOL

APPLICATION ALL OVER BODY FOR APPROXIMATELY ONE YEAR.

TINEA CORPORIS

DENOVO HTN .

The treatment includes:

Dose of Tab hizone was reduced to 10 mg per day in divided doses for one month.

In view of low back ache Xray LS spine was done which was normal and pt was advised.:

Tab Shelcal 500 OD and Tab Vit D 3 Od.

Tab ULTRACET /PO/SOS.

Psychiatry opinion was taken and he was diagnosed with moderate depression , which was very well said.

All the chief complaints of the patient, History and Investigations of the patient are thoroughly explained.

All the suitable Investigations were done which led to this diagnosis. 

The Diagnosis of the patient was very well explained.

The above elog was relevant in respective to the case with all the fine details.


QUESTION 2 and 3:

Case 1:

Diagnosis include:

Acute Glomerulopathy (Glomerulonephritis / Nephrotic syndrome)

Bilaterally Symmetric Chronic Progressive Inflammatory Peripheral Polyarthritis

Investigations were:

• X Ray

• AP view of hand and wrist

• PA view of chest X RAY

• Standard 12 lead ECG

• ECG

• 24 hrs Urinary protein

• 24 hrs Urinary Creatinine

• Urine Microscopy

Treatment:

Free water restriction for Hyponatremia

Tab. PREDNISOLONE P/O 20 mg OD

Tab FEBUXOSTAT P/O 80 mg OD

Haemodialysis for worsening renal dysfunction

Case 2:

Diagnosis:

1. Idiopathic Parkinson's Disease Stage 1 with denovo HTN.

2. Multiple System Atrophy - Parkinsonian Type (MSA-P).

Investigations:

• ECG

• 2D ECHO

Treatment:

1. Tab. Syndopa Plus 125 mg QID

2. Tab. Syndopa 125 mg CR OD

3. Tab. Telma 40 mg OD

Case 3: 

Diagnosis:

IATROGENIC CUSHINGS SYNDROME

SECONDARY TO TOPICAL CLOBETASOL

APPLICATION ALL OVER BODY FOR APPROXIMATELY ONE YEAR.

TINEA CORPORIS

DENOVO HTN .

Investigations:

INVESTIGATIONS :

CBP - HB - 13.4 g/dl 

TLC - 6,800

PLT - 1.5 lakhs.

RBS - 139 mg/dl 

CUE - ALBUMIN - +1 

SUGARS - NIL .

PUS CELLS - 3-4 

RBC - NIL .

LFT - TB -1.03

DB-0.21

ALBUMIN - 3.9

RFT - UREA - 22 

SERUM CREATININE -0.6

ELECTROLYTES - NA - 136 

K- 4 

CL-98 

USG ABDOMEN - NORMAL.

ECG - SINUS TACHYCARDIA 

LVH PRESENT.

Treatment:

Dose of Tab hizone was reduced to 10 mg per day in divided doses for one month.

In view of low back ache Xray LS spine was done which was normal and pt was advised.:

Tab Shelcal 500 OD and Tab Vit D 3 Od.

Tab ULTRACET /PO/SOS.

Psychiatry opinion was taken and he was diagnosed with moderate depression .


QUESTION:4

https://76eashachandrika.blogspot.com/2021/07/general-medicine-assessment_10.html


QUESTION:5

Doing all the above cases was so helpful and also looking at all those cases was so informative.

We're very happy that we had a chance to do all these by ourselves.

We're very much grateful for our general medicine department for helping us being so interactive even in these hard times.



Comments

Post a Comment

Popular posts from this blog

Gen med elog

Image
  35YR MALE WITH C/O ABDOMINAL SWELLING This is an online E log book to discuss our patient's deidentified health data shared after taking his/her/guardian's signed in formed consent.Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence-based inputs . A 35 year old male house contractor by occupation from Miryalaguda came to general medicine OPD with chief complaints of swelling in feet and abdomen since 2days  Tingling sensation,cought since 1 week , difficulty in intake of food. History of presenting illness:  Patient was apparently asymptomatic 2days back then he developed edema in lower limbs  which is  insidious in onset gradual in progression  and pitting type? and then he developed  swelling in abdomen insidious  onest gradual progression h/o nausea ,tiredness and tingling sensation after eating food 
Read more

GENERAL MEDICINE ASSESSMENT

Image
   M easha chandrika    Rollno:76    Below is an E-log describing patient centered data approach and discussion regarding patient de- identified health data                                            this e log is made under the guidance of Dr.kranthi mam [intern] CASEHISTORY: 18 yrs old patient came to casuality  CHIEF COMPLAINTS;   weakness of both Lower limbs and was unable to stand and walk HISTORY OF PRESENT ILLNESS: ▪︎weakness of lower limbs  ▪︎unable to stand  ▪︎unable to walk HISTORY OF PAST ILLNESS: ▪︎H/o seizure episodes  ▪︎unable to walk till 6 yrs  ▪︎difficulty in studying and writing till  6yrs ▪︎she went for urination and suddenly she couldn't getup on her own she was taken to hospital and was diagnosed hypokalemia  ▪︎she took herbal medication later she developed nausea and vomitings and was taken to hospital and later she was diagnosed Dyselectrolytemia ▪︎then after she developed spasm of upper limbs ▪︎pedal edema (grade 1) 2months back                             
Read more

Gen med blog :fever and cough with sputum

  This is case of 83yr old male came with complaints of cough with sputum since 4 days,breathlessness since 4 days. Patient was apparently asymptomatic 4days back then he developed  cough which was insidious in onset, gradually progessive associated with sputum which was white in colour ,copious  amount. Fever since 4 days,high grade, associated with chills and rigors Breathlessness since 4 days which was insidious in onset , gradually progressive from grade 2 to grade 4 No h/o chest pain, orthopnea,pnd, palpitations,pnd PAST HISTORY: Patient is not a known case of Hypertension, Diabetes mellitus, TB, Epilepsy, Bronchial asthma, Thyroid disorders PERSONAL HISTORY: Diet - Mixed Appetite - decreased Sleep - Adequate Bowel and Bladder movements- Regular Addiction - consumption of alcohol occassionally,h/o smoking since 30 yrs (1pack per day) GENERAL EXAMINATION  Patient is conscious, coherent and cooperative and well oriented to time, place and person He is moderately built There is prese
Read more