General Medicine assignment

  General medicine monthly online summative assesment

Likitha Godavarthi

roll no: 69

General medicine assignment(3rd sem)

 

QUESTION-1

1. CARDIOLOGY

REVIEW: https://dthanmai27.blogspot.com/

CASE: https://preityarlagadda.blogspot.com/2021/05/biatrial-thrombus-in-52yr-old-male.html

This is a case of atrial fibrillation and biatrial thrombosis. patent is a known patient of hypertension which might have let to the formation of thrombus. due to the formation of thrombus cardiac output was low leading to decreased GFR leading to the increased action of renin and aldosterone . increased aldosterone leads to sodium retention . this explains the puffiness of her face .dytor was recommended as it has antagonistic actions against aldosterone.

2.NEUROLOGY

REVIEW: https://dthanmai27.blogspot.com/2021/05/online-blended-bimonthly-assignment.html

 CASE: https://kausalyavarma.blogspot.com/2021/05/a-52-year-old-male-with-cerebellar.html?m=1

This is a case of cerebellar ataxia. patient has hypertension and prescribed medication which he has not taken. symptoms include deviation of mouth and there was no slurring of speech. Stroke due to an infarct can be caused by blockade or bleeding in the brain due to which blood supply to the brain is decreased depriving essential oxygen and nutrients. 

3. GASTROENTEROLOGY 

REVIEW:https://santhoshdarimedi.blogspot.com/2021/05/medicine-blended-assignment.html

CASE:https://63konakanchihyndavi.blogspot.com/2021/05/case-discussion-on-pancreatitis-with.html

This is a case of pancreatitis pseudocyst and left broncho pleural fistula. symptoms include pain in the abdomen, constipation and burning micturiton. Amikacin , metrodinazole and meropenem are given to control the infection. Inj octrotide is given to decrease the secretion of pancreas. TPN is given so Inj thiamine is given as B1 supplement.

4.NEUROLOGY

REVIEW:https://divyaraju266.blogspot.com/2021/05/answers.html

CASE:https://amishajaiswal03eloggm.blogspot.com/2021/05/a-50-year-old-patient-with-cervical.html

 

This is a case of cervical myelopathy. Patient was asymptomatic and developed weakness of all four limbs which was sudden and preceded the history of alcohol binge. There is a loss of power of adduction and extension of the ulnar two or three fingers and an inability to grip and release rapidly which is known as myelopathy hand. The patient is advised for C3-C6 screw fixation, C3-C6 lamenectomy.

5.NEUROLOGY 

REVIEW:https://divyaraju266.blogspot.com/

CASE:https://143vibhahegde.blogspot.com/2021/05/wernickes-encephalopathy.html

This is a case of altered sensorium .patient presented with the symptoms of short term memory loss and seizures and patient has a known history of type 2 diabetes. he also has a history of alcohol consumption and cigarette smoking. alcohol contains ethanol which is a depressant of central nervous system. this explains why he has altered sensorium because sudden with drawl form alcohol leads to sensitization of GABA  receptors.

6.CARDIOLOGY

REVIEW:https://divyaraju266.blogspot.com/2021/05/answers.html?m=1

CASE: https://muskaangoyal.blogspot.com/2021/05/a-73-year-old-male-patient-with-pedal.html

This is the case of a 72 year old patient with pedal edema and shortness of breath and decreased urinary output. Reason can be diabetes as diabetic patients have an increased risk of developing heart failure because of the abnormal cardiac handling of glucose and free fatty acids and because of the effect of the metabolic derangements of diabetes on the cardiovascular system. 

8. PULMONOLOGY

REVIEW: https://divyaraju266.blogspot.com/2021/05/answers.html?m=1

CASE:https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html

This is the case of Acute exacerbation of COPD associated with right heart failure and bronchiectasis. The low oxygen levels due to COPD causing pulmonary hypertension. This increase in pressure results in right sided heart failure. Bipap is given for consistent breathing pattern and inj lasix is given to decrease the blood pressure by increasing sodium and water.

9 .HEPATOLOGY

REVIEW:https://divyaraju266.blogspot.com/

CASE:https://kavyasamudrala.blogspot.com/2021/05/liver-abscess.html

This is a case of liver abscess. consumption of local alcohol might have lead to liver abscess. decreased movements in the right upper quadrant are observed this might tell us that the right lobe of liver was affected. this is due to fact that right lobe has more blood supply which includes portal vessels. local alcohol contains many microorganisms which might have infected the blood leading to liver abscess.

10.CARDIOLOGY

 

REVIEW: https://divyaraju266.blogspot.com/2021/05/answers.html

 

CASE: https://daddalavineeshachowdary.blogspot.com/2021/05/67-year-old-patient-with-acute-coronary.html?m=1

 

This is a case of acute coronary syndrome in patient with diabetes mellitus and past history of TB. She presented with sweating and ECG showed characteristics for an NSTEMI that are depressed ST wave, no progression of Q wave. Medication was given and a PCI was recommended. It is coronary angioplasty for treating cardiac diseases.

QUESTION 2

I haven't gotten a chance to make a case report. I am still executing the cases which are present in our group .I will perform the next case in E log.

QUESTION 3 and 4

https://61tejarshini.blogspot.com/2021/06/general-medicine-case-discussion.html?m=1

This is a case of hypertensive nephropathy.

symptoms include altered sensorium ,shortness of breath, lethargy .patient has a known history of hypertension and chronic kidney disease. his creatinine levels were high(11-14.8). patient was also complaining of back and neck pain.

general examination of the patient tells us that pallor is present.

in systemic examination of the patient it can be inferred that dyspnoea is present which means patient is suffering from breathing difficulties and he is hypoactive.

treatment-lasix is given to the patient. it helps in decreasing the hypertension and also acts as a diuretic and increases production of urine which further decreases hypertension.

sodium bicarbonate is also given to adjust the blood pressure and it also inhibits the angiotensin converting enzyme therefore prevents the increase in blood pressure by decreasing the absorption the water.

QUESTION 5

Online clinical postings have been really challenging for all of us but our general medicine department was very helpful. These interactive lectures were very encouraging. We have learnt how to take patient history, make a case report and monitor a patient. It’s all thanks to the efforts of the general medicine department in passing along their knowledge and bridging the gap between classroom and clinical knowledge.