Bimonthly blended assessment

Name - Bhavya Ranjan 

Roll no. -17

Batch - 2019( third sem)

Question 1) Peer review of one particular answer of 10 randomly selected  students. 

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

The case is reviewed  and explained very well .

The necessary questions were posed and checked,reviewed and assesed appropriately taking into the consideration of patients history, diagnosis and also the treatment partof the diagnosed  disease.

The patient was talking,as well as laughing to himself. He was also unable to lift himself off the bed and move around,and had to be assisted.

All the above things are signs of mental confusion.

He was alcoholic, had stopped drinking .he

developed seizures following cessation of alcohol for 24 hrs, which was associated with restlessness, sweating and tremors.

All the above are signs of alcohol withdrawal delirium.

Albumin is decreased,this may indicate liver or renal problems.

Question 2:

I haven't yet got the chance to do the elog. I will try best to do elog when I get a chance.

QUESTION 3

Case 1:- AKI   Link to the case is below :

Link to the case is below : rikantoju.blogspot.com/2021/07/58-year-old-male-patient-elog-lahari.html?m=1

⇒Scenario of the case is depicted very well. Along with the treatment history and complains which are described correctly for easy analysis. Many investigations done are which are done are placed very well according to date.

Case2:-Patient with AKI Link to the case is below :

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

The patient is alcohol addict. Due to increased alcohol intake liver cannot process it which leads to inflammation causing to alcohol hepatitis,

He is diagnosed with acute gastroenteritis.the virus infects the small intestine lining and increase its permeability causing watery diarrhoea.It also leads to low blood flow to kidney causing AKI.

Urine output decreases.

The inflammation of liver slows down the blood flow through it,thus there is increase in pressure in veins which bring blood to liver.

Case 3:-Patient with acute on CKD Link to the case is below

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

In this case patient presented to opd with complaint of shortness of breath.He was also having history of chronic renal failure and heart failure.

Provisional diagnosis of this case is Heart failure reduced ejection fraction (hfref) secondary to coronary heart disease; coronary renal failure.

When you have heart disease, your heart may not pump blood in the right way. Your heart may become too full of blood. This causes pressure to build in the main vein connected to your kidneys, which may lead to a blockage and a reduced supply of oxygen rich blood to the kidneys. This can lead to kidney disease.

The shortness of breath in heart failure is caused by the decreased ability of the heart to fill and empty, producing elevated pressures in the blood vessels around the lung

Case 5:- Patient with coma and renal failure   Link to the case  is below: 

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

⇒This is bit of complicated case as he was diagnosed with AKI secondary to UTI on CKD.  Icterus and pedal edema are seen.

Case 6 :- Patient with acute on CKD     Link to the case is below :

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

⇒Post TURP with non oliguria ATN. It is a classical case where pus is seen in urine. There is a history of Transurethral Resection of Prostrate. Hydronephrosis is beautifully explained with MRI scans.

Case 7 :-  Patient with acute on CKD     Link to the case is below :

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

⇒He is a known case of DM and hypertension which make him more prone to diseases. LFT and RFT are quite abnormal. HFrEF secondary to CAD is the diagnosis.

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: 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 3
Diagnosis:  Chronic interstitial nephritis secondary to plasma cell dyscariasis
Treatment:   
- T. PAN 40mg /PO / OD
- oral fluids upto 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 learning process has become a stressful challenge for both students and staff during a truly challenging pandemic circumstance. However, this learning process must continue uninterrupted. As a result, our institution and faculty are working hard to ensure that online e-learning classes run smoothly and regularly, allowing students to understand and learn the clinical characteristics of patients. Our academics, interns, and pgs are all working hard to make this happen. Despite the fact that it is a challenging work for us (students), we are doing our best to grasp the material.These case presentations and elogs are all challenging for us right now, but they are assisting us in learning some history taking, diagnosis, aetiology, and clinical aspects to some level. I appreciate all of our institution's efforts, and I am hopeful that this pandemic will be over soon, as we are ready to resume our offline classes.