GENERAL MEDICINE ASSESSMENT

 I am  P. Sri Chandana, MBBS 3rd semester,

Roll. No: 98.

QUESTION 1:

https://99vaishnavireddy.blogspot.com/2021/07/general-medicine-assessment.html

• The case done by my closest number was           PULMONOLOGY.

REVIEW:

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

• 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:

https://98chandanapadi.blogspot.com/2021/07/i-am-p.html


QUESTION 3:

CASE 1:

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

 Acute kidney injury( AKI)  2° to UTI, associated with Denovo - 

Patient is a known case of diabetes mellitus and hypertension.

Patient had sudden onset of pain in abdomen 

By burning micturation with high fever : grade associated with chills and rigor 

Decrease urine output associated with SOB (grade -4)

With no H/O chest pain, palpitations, pedal oedema, facial puffiness.

Blood urea and Creatinine levels of the above patient are very high which explains the Acute kidney injury.

The above case was very well explained.

CASE 2:

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

This is a case of Acute renal failure and hyperuricemia 2° to renal failure.

He had lower backache , dribbling of urine and pedal edema.

Blood urea, uric acid and Creatinine  levels of the above patient are very high which explains the Acute renal failure.

Dribbling may be caused due to obstruction of bladder.

The above case was very well explained.

CASE 3:

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

The above patient was diagnosed with Chronic interstitial nephritis secondary to plasma cell dyscariasis.

Levels of Serum Creatinine and Blood Urea are high which explains nephritis.

The above case was very well explained.

CASE 4:

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

This is the case of Diabetes keto acidosis with acute kidney injury.

DKA is associated with hyperglycemic crises and featured by metabolic acidosis, the production of ketoacids, volume depletion, and electrolyte imbalance. Due to glucose-induced osmotic polyuria and even emesis, volume depletion is a major cause of acute kidney injury (AKI) in DKA patients.

The above case was very well explained.

CASE 5:

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

This is a case of Uremic Encephalopathy.

Uremic encephalopathy is an organic brain disorder. It develops in patients with acute or chronic renal failure, usually when the estimated glomerular filtration rate (eGFR) falls and remains below 15 mL/min.

The above case was very well explained.

CASE 6:

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

This is a case of Renal AKI secondary to urosepsis with b/L hydroureteronephrosis.

He was also diagnosed with diabetic nephropathy with Anemia secondary to CKD with grade 1 bed sore.

Septic acute kidney injury (AKI) is a syndrome of acute loss of renal function and organ damage, defined by the simultaneous presence of both Sepsis-3 and KDIGO criteria. AKI is a common complication of sepsis.

The above case was very well explained.

CASE 7: 

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

This is a case of HFrEF secondary to CAD; CRF

The above case is explained well.

CASE 8:

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

This is a case of ALCOHOLIC HEPATITIS ,

AKI SECONDARY TO ACUTE GASTROENTERITIS.

This is a condition in which the kidneys suddenly can't filter waste from the blood.

The above case is explained well.


QUESTION 4:


CASE:1

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

DIAGNOSIS:

Acute kidney injury( AKI)  2° 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


6)INJ     HAI  S/C  ACC  TO   SLIDING SCALE

              8AM  -  2PM  -  8PM


7)SYP    LACTULOSE   15ml    PO/TID [ To maintain stools less than or equal to 2]


8) GRBS  - 6th Hourly


9) BP/PR/TEMP - 4th Hourly


10) I/O - CHARTING

CASE:2

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

DIAGNOSIS:

Acute renal failure

Hyperuricemia 2° to Renal failure 

TREATMENT:

• Inj. Ciprofloxacin 500mg-OD

• Tab.Febuxostat 40mg -OD

• Tab.Neurobion forte -OD

• Tab.pantop 40mg-OD

• Syp.mucaine gel 15ml -TID

• Limb elevation- Crepe bandage

• Monitor Bp,PR ,Temperature ,spo2

• Oral fluids upto 2-3L/day

•Tab.Ultracet 1/2 tab.-QID

CASE:3

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

DIAGNOSIS:

Chronic interstitial nephritis secondary to plasma cell dyscariasis

TREATMENT:

-inj.optineuron 1 amp in 500ml NS IV/OD

-ivf. NS RL @ uo + 30 ml/hr

-inj. erytropoitin 4000 iv s/c weekly twice

-tab.pan-d po/od (8 am)

-tab.orofer-xt PO/BD

-tab.nodosis 500mg PO/BD

-protein- x powder 2 tsp in 1 glass of milk PO/TID

-tab. zofer 4mg PO/sos

-BP/PR/Temp - 4th hrly

- I/o - charting 

CASE:4

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

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

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

DIAGNOSIS:

UREMIC ENCEPHALOPATHY

HYPOALBUMINEMIA

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

5. Inj. Thiamine 200mg in 100ml NS /BD

6. Inj. HAI 6U S/C TID

CASE:6

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

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

Injection NEDMOL 100ml IV/SOS

Tab PCM 650mg TID

Insulin Human actrapid - 16 IU/TID

CASE:7

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

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

6.Cap. BIO-D3 OD

7.Cap. GEMSOLINE OD

8.TAB. ECOSPRIN-AV 150/20mg OD

9.TAB.LASIX 40mg BD

10. SYP. LACTULOSE 15ml

CASE 8:

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

DIAGNOSIS:

ALCOHOLIC HEPATITIS ,AKI SECONDARY TO ACUTE 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

TAB. ALDACTONE 50 mg PO / BD

INJ PANTOP 40 mg IV/ OD

ABDOMINAL GIRTH MEASUREMENT DAILY

BP /PR/TEMP/ RR -4 hourly 

I/O CHARTHING


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.

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