Vasavi 100

 BIOMONTHLY ASSIGNMENT -JUNE 2021

This is a bio monthly blended assignment of general medicine regarding the cases presented in the month of june . The assignment is the review of the cases .

QUESTION 1 competency tested for peer review 

https://amishajaiswal03eloggm.blogspot.com/

PULMONOLOGY

Case 1:https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html

Review: This is a case of a 55 yr old female patient with provisional diagnosis of acute exacerbation of COPD associated with heart failure and brochiectasis. The patient came with the chief complaints of shortness of breath , pedal edema and facial puffiness. she also has the history of type 1 diabetes mellitus and hypertension. The presentation of the investigation  regarding the diagnosis were presented in an order. The anatomical localization of the problem is at the brochioles due to exposure to dust or allergens in the paddy feilds. 

NEUROLOGY

Case 2:https://143vibhahegde.blogspot.com/2021/05/wernickes-encephalopathy.html

Review: This is case of a 40 yr old male patient who was talking to himself and at the same time laughing to himself. He also had short term memory loss by which he couldn't recognise his family members. The provisional diagnosis is wernicke's encephalopathy secondary to chronic alcohol dependence , uraemic encephalopathy and alcoholic withdrawal delirium. He was alcohol and cigarette addict that caused this state .There was a clear explanation regarding the cause of alcohol causing the disease. It is mentioned that ethanol is a CNS depressant that produces euphoria and behavioral excitation. And also mentioned the mechanism of drug action.

NEUROLOGY

Case 3:https://kausalyavarma.blogspot.com/2021/05/a-52-year-old-male-with-cerebellar.html?m=1

Review: This is a case of cerebellar ataxia. The patient is a 52 yr old male presenting with slurring of speech and deviation of mouth. He was found to have DENO HTN, and no history of diabetes. He is chronic alcoholic and smoker. The anatomical location of the disease is cerebral blood vessels and the primary etiology is DENO HYPERTENSION in the patient. Hypertension predisposes to stroke by aggravating atherosclerosis and causing arteriosclerosis and lipohyalinosis in the penetrating cerebral end arteries . There is also contribution of the chronic alcoholism to this disease, which is decreasing the risk of the ischemic stroke but damaging the liver and stopping it from synthesis of proteins responsible for blood clotting .

Case 4:https://nikhilasampathkumar.blogspot.com/2021/05/a-48-year-old-male-with-seizures-and.html?m=1

Review: This is a case of a  48 yr old male who came with chief complaints of unresponsiveness and intermittent episodes of seizures. He is addicted to alcohol and toddy. The provisional diagnosis is generalized tonic seizures secondary to acute hemorrhage in the frontal , temporal ,and parietal lobes. Alcohol related cerebellar degeneration is one of the commonest causes of acquired cerebellar ataxia. The diverse harmful effecting mechanisms were clearly detailed.

CARDIOLOGY

Case 5:https://muskaangoyal.blogspot.com/2021/05/a-78year-old-male-with-shortness-of.html

Review:  This is a case of 73 yr old male who came with chief complaints of pedal edema, shortness of breath and decreased urine output. He is also a known patient of diabetes and hypertension. The diagnosis is heart failure with preserved ejection fraction .He was advised salt restricted diet and also fluid restriction. 

QUESTION 2:

I didn't prepare an e-log in this month , may be in the next month.

QUESTION 3:https://61tejarshini.blogspot.com/2021/06/general-medicine-case-discussion.html?m=1

This is a case of hypertensive nephropathy with uremic encephalopathy. The patient came with chief complaints of lethargy, fever, pedal edema with anasarca with shortness of breath. The report of the CBP was normocytic hypochromic anemia. On general examination he was drowsy but arousable and pallor. From  CUE it appears there are pus cells and epithelial cells in the urine more than the normal range. The ultrasound investigations were fatty liver, simple renal cyst in the left kidney.

QUESTION 4:https://60shirisha.blogspot.com/2021/06/medicine-case-discussion_14.html?m=1

This is a case of a 70 yr old female who presented with chief complaints of distension of abdomen and shortness of breath . She is a known case of hypothyroidism since 5 yrs and was on Thyronorm  100mg OD for hypothyroidism. The diagnosis is HFrEF with atrial fibrillation. The diagnosis was confirmed based on the investigation showing atrial fibrillation in ECG and 2D echo showing B/L pleural effusion and mild pericardial effusion. Her biochemical report showing severe hyperthyroidism possibly relating to her refractory atrial fibrillation. And was treated with inj. amiodarone 150mgIV stat, inj. Amiodarone infusion and inj. clexane 40mg Sc OD and defebrillation also has been attempted. Amiodarone acts by blocking potassium rectifier currents that are responsible for the repolarisation of the heart. The defibrillator uses the high voltage current by which the potential to whole atria passes at the same time and contracts and again the normal potential of the cells can be maintained and the re-enterant circuit is lost.

QUESTION 5:

The experience of learning from hospital seeing the patient for me is the first time after entering this field . We had some cases in first year related to our anatomy classes  but not in the hospital. This knowledge of performing the examination and discussing the diagnosis by knowing everyone's point of view is really helpful. Though these are online classes we are able to get some knowledge but we are not having the clarity regarding it. As this our first time it may be difficult  but as time passes it would be easy and more knowledge gaining.