BIMONTHLY ASSIGNMENT OF MEDICINE FOR JUNE 2021

QUESTION 1:-

  https://medicinedepartment.blogspot.com/2021/06/medicine-department-paper-for-june-2021.html?m=1

1) INFECTIOUS DISEASE (COVID-19)

PATIENT DETAILS: 

https://nikhilasampathkumar.blogspot.com/2021/05/covid-pneumonia-in-pre-existing-case-of.html

REVIEW FOR THE LINK:

https://meesumabbas82.blogspot.com/2021/05/case-opinions-may-2021.html

#Explained about Importance of ILD in the prognosis of COVID Patients. Provided reference link to study about effects of using steroids in COVID patients (https://www.health.harvard.edu/blog/does-lupus-or-arthritis-affect-your-prognosis-if-you-get-covid-19-2020110921230#:~:text=There%20was%20some%20good%20news,prognosis%20for%20the%20arthritis%20patients.) #Role of the autoimmune response in COVID Patients (https://www.healio.com/news/rheumatology/20210329/covid19-more-severe-than-influenza-in-patients-with-autoimmune-disease)

PERFORMANCE: - 9/10

 

2) GASTROENTEROLOGY (& PULMONOLOGY)

 

PATIENT DETAILS:

nakanchihyndavi.blogspot.com/2021/05/case-discussion-on-pancreatitis-with.html

 REVIEW FOR THE LINK:

https://sofiajabeen1912.blogspot.com/2021/05/pulmonogy-1.html

#The timeline of symptomatology is illustrated briefly in a photograph. Efficacy and mechanisms of drugs are explained in brief.

PERFORMANCE: -8/10

 

3) PULMONOLOGY

PATIENT DETAILS:

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

REVIEWS FOR THE LINK:

http://haqansariblogformonthlyassiggnment.blogspot.com/2021/06/questions-1-what-is-evolution-of.html

#Reasons for her exacerbation are true because she is continuously exposed to allergens [paddy and pollen], also due to viruses like rhinovirus, influenza, pneumococcus. The reason for the patient's SOB is explained properly i.e., due to pollen and dust from paddy fields. Anatomically it is localized to lower airways [from CT Finding] and etiology lies in the fact that the patient had been chronically exposed to lung irritants. Even in my view placebo cannot relieve any of the patient's discomfort and I agree with chest physiotherapy, head-end elevation, BiPaP-augmented lung expansion. MEDICATION; azithromycin, Lasix, nebulization with budecort. yes, drug-induced hyponatremia i.e., telmisartan could have caused electrolyte imbalance.

PERFORMANCE: -9/10

 

4) NEPHROLOGY

 

PATIENT DETAILS:

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

 

REVIEW FOR THE LINK:

https://abhignyareddy71.blogspot.com/2021/05/online-blended-bimonthly-assignment.html

#The cause for SOB is correct (i.e., due to usage of diuretics). The cause for drowsiness is effectively illustrated in a photograph. Plenty of pus cells in his urine passage appeared as fleshy mass-like passage, there could be parenchymal damage is the proper explanation.

PERFORMANCE: -9/10

 

5) INFECTIOUS DISEASE AND HEPATOLOGY 

 

PATIENT DETAILS:

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

 

REVIEW FOR THE LINK:

https://muskaangoyal.blogspot.com/2021/05/bimonthly-clinical-case-assignment-1.html

#Adverse effects of consuming locally made alcohol are explained. Etiopathogenesis of liver abscess in a chronic alcoholic patient is illustrated. The probability of Liver abscess in its lobes is demonstrated.

PERFORMANCE: -8/10

 

6)NEUROLOGY

PATIENT DETAILS:

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

REVIEWS FOR THE LINK:

 https://mdparvezahmedansari.blogspot.com/2021/06/medicine-blended-assignment.html

#Etiology is stated accurately i.e., alcohol withdrawal and symptomatology stand the same [seizures, tremors, restlessness] Thiamine, lorazepam, are standard medication in my view. Alcohol withdrawal symptoms will fit the best. It is the right decision to give thiamine since it is majorly involved in ATP and NADH production. Dehydration is the only probable cause for dehydration in my view. The mentioned reason is appropriate i.e., alcohol decreases iron absorption and the bleeding ulcer is cause for normocytic anemia.

PERFORMANCE: -9/10

 

 

7) INFECTIOUS DISEASE (HI VIRUS, MYCOBACTERIA, GASTROENTEROLOGY, PULMONOLOGY)

PATIENT DETAILS:

 

https://vyshnavikonakalla.blogspot.com/2021/05/a-40-year-old-lady-with-dysphagia-fever.html

 

REVIEW FOR THE LINK:

 

https://srinithya27.blogspot.com/2021/05/genral-medicine-e-blogs.html

#The clinical symptoms chose will exactly diagnose trachea esophageal fistula. Prevention methods advised are best suited.

PERFORMANCE: -9/10

 

 

8) INFECTIOUS DISEASE (MUCORMYCOSIS, OPHTHALMOLOGY, OTORHINOLARYNGOLOGY, NEUROLOGY) 

 

PATIENT DETAILS:

http://manikaraovinay.blogspot.com/2021/05/50male-came-in-altered-sensorium.html

REVIEW FOR THE LINK:

https://143vibhahegde.blogspot.com/2021/05/medicine-blended-assignment-may.html

#Symptomatology is described briefly event-wise according to the following dates. Mechanism and Efficacy are properly illustrated in the photograph sequentially.

PERFORMANCE: -8/10

 

 9) CARDIOLOGY

PATIENT DETAILS:

https://muskaangoyal.blogspot.com/2021/05/a-78year-old-male-with-shortness-of.html.

REVIEW FOR THE LINK:

https://meesumabbas82.blogspot.com/2021/05/case-opinions-may-2021.html

#Differences between heart failure with preserved ejection fraction and with reduced ejection fraction are explained in detail. causes for Heart failure with reduced ejection fraction are also mentioned. the decision not to perform an unnecessary procedure [pericardiocentesis] was wiser. The list of risk factors for heart failure stands true here.

PERFORMANCE: -9/10

 .

 

10) MEDICAL EDUCATION

This pandemic presents practical and logistical challenges and concerns for patient safety, recognize the students may spread the virus asymptomatically or may acquire the virus in the course of training. So, this blogging experiences for medicine cases and queries about patient-related problems are very helpful during this pandemic.

QUESTION 2:-

https://ankesh017.blogspot.com/2021/07/41-year-old-male-patient-with-history.html

QUESTION 3&4:-

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

 The patient fell down suddenly followed by weakness of lower limbs, lost his grip in hand, and also suffered from bowel and bladder incontinence. attendants brought him to OPD after 10 days of his fall. he is a known case of TB and on ATT medication. the patient had already developed weakness since 15 days back.-- as he has paraplegia, weakness my first thought process to approach this case is to start with neurological anomalies, and his bladder and bowel incontinence (loss of control over the smooth muscle) will also indicate any sort of lesions within the CNS.

REASONS FOR PERFORMING TESTS:-

#ECG: as the patient was hypertensive for 5 years, by doing an ECG we can rule out any cardiac complications that may have exaggerated. 

#BLOOD UREA, CREATININE, SERUM ELECTROLYTES: the patient is on ATT so there is a side effect of these drugs which may cause renal failure, therefore we can rule out any kidney-related complication.

#COMPLETE BLOOD PICTURE(CBP): based on the count of cells we can rule out or can guess if there is any infection.

#CHEST X-RAY: to check for any presence of cardiomegaly.

#MRI BRAIN WITH CERVICAL SPINE: the report has shown the site of the lesion from above all investigations it was diagnosed as Quadreparesis secondary to infectious spondylitis of C4, C5, C6, C7, and D1 with Epidural abscess at C5 - C6 level.

From above all investigations it was diagnosed as:-

• Quadreparesis are secondary to infectious spondylitis of C4, C5, C6, C7, and D1 with Epidural abscess at C5 - C6 level.

 TREATMENT:- 

1.  Inj. Optineuron 1Amp in 100ml NS  IV/OD - is given to subside his neurological manifestations.
2. ATT - according to bodyweight 2 tab PO/OD -  for his TB.
3. Thiamine - is given to boost his immune system to fight against infectious spondylitis and also for treating some of his neurological problems.

QUESTION 5:-

In my opinion, seeing the healthcare situations and opportunities in the present time it is very right to say that "telemedicine is the need of today". With the help of telemedicine, a person having any health issue can get the most immediate and required medical advice/medication in the safety and comfort of their homes by making use of digital technologies. This elog plays a major role in this condition which gives the doctor idea about the patient's history of present illness, family history, and investigations for the diagnosis and treatment of the disease. During this time, I have had a virtual clinical exposure along with online lectures where I learned the basics of patient care such as history taking, general and systemic examination.  Along with this, I also read through several medical blogs of various systemic disorders which helped me understand several pathological changes that occurred in contrast to the physiological mechanisms that I had learned last year. Something new that I learned with this was various investigations that are to be performed with specific signs and symptoms and differentials that can be drawn from them. I learned how to blog which is definitely a prized possession for me. I will keep nurturing and expanding this blogging that I’ve had and would love to indulge in such activities in the future too.

     I would like to thank Dr. Rakesh sir for providing me an opportunity to be able to create blogs and knowing about the patient's complications in detail. I would also like to thank Dr. Kusuma ma’am for guiding me to be able to cope up with the subject even during this pandemic.