JULY ASSESSMENT

 

July assesment

 All questions are around student driven patient centered case reports prepared by our students (including 2019 batch students in 3rd semester) over last one month. For the same students taking this exam, separate marks will be provided for their contribution to the questions. 


Question 1: Competency tested for Peer to peer review and assessment :

Please go through one student's entire answer paper from this link, the one who is closest to your own roll number 

http://medicinedepartment.blogspot.com/2021/07/2019-batch-medicine-department-online.html?m=1


and share your peer review of each answer with your qualitative insights into what was good or bad about the answer. 


Case 1 

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

Diagnosis COPD secondary to Bronchiectasis

MY OPINION:-

Could be an acute exacerbation of COPD

As positive history of exposure to allergens due to occupation and seasonal variation

Overall the review is appropriate 

Could have shared more clinical images



Case 2 

https://swathibogari158.blogspot.com/2020/09/chronic-decompensated-liver-disease.html

Diagnosis : cirrhosis of liver and ascites .

 MY OPINION:-

   I agree with cirrhosis of liver  being the cause of hyperbilirubinemia

  Patient is a chronic alcoholic  with ascites  causing hypoalbuminemia and reduced aldosterone synthesis .

Advising dietary intake of 2eggs is a good nutrition supplement to increase protein(albumin)

On the whole it was good

But more emphasis can be made on trying to link the conditions



   Case 3 

https://lasyamithrakandregula.blogspot.com/2021/05/medicine-cases.htmlhttps://lasyamithrakandregula.blogspot.com/ 

 Diagnosis : viral pneumonia with known case of hypothyroidism .

 MY OPINION:-detailed way of presentation

Could have added fever chart also


Case 4 

http://psaikrupasri175.blogspot.com/2021/05/medicine-case-discussion.html.

 Diagnosis : patient was diagnosed with Arthralgia and a known case of diabetes mellitus type 2 

 OPINION:-more clinical history and relevant images could have been shared rather than more emphasis on the treatment


CASE :5 https://bejugamomnivasguptha.blogspot.com/

Question :  Is there any relationship between occurrence of seizure to brain stroke. (3 m)

Review : it is obviously true that shock may lead to seizures .

Shock ➡️scar formation in brain ➡️it disrupt electrical signal ➡️it leads to seizures .so the explanation in this answer is exactly true 

MY OPINION:-

Patient came to opd with chief complaints of palpitations, pedal oedema, chest heaviness, radiating pain along the left upper limb. Patient was diagnosed with cervical spondylosis and recurrent hypokalemic paralysis.

About the answers given..anatomical localisation is mentioned and primary etiology is discussed deeply.. And causes of the symptoms are explained and possibility of other diseases are mentioned. Tables are used to explain clearly.. Risk factors of hypokalemia are mentioned and ecg changes in hypokalemia are explained with diagram. Usage of tables and diagrams made this presentation a bit more effective.


CASE 6:-

Case :https://budigesaikiran14.blogspot.com/

Diagnosis : alcohol induced cerebellar ataxia 

Review : Reasons for cerebellar ataxia is very well discussed .

It is due to damage to GABA -A receptor impaired glucose metabolism vit B1 deficiency .the way of answering a question is so attractive and it is easy to understand .

MY OPINION:-

The symptomatology has been explained in a chronological order of occurrence.

The primary etiology of the patient has been mentioned with the necessary finding along with the pictorial representation.

The anatomical location of the problem has been described.

The mechanism of action was very well explained with the action of the pharmacological drugs administered.

The answers for the given questions were commendable along with the usage of statistics


CASE 7:-

https://aniganikavya06.blogspot.com/

 Diagnosis :Acute exacerbation of COPD associated with right heart failure and bronchiectasis.

Review :  What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patient's problem?

 Anatomical Location of problem-Lungs- Bronchi and bronchioles

  Primary etiology- Usage of chulha since 20years

Answer explained is appreciable .every thing is really so point to point and easily understandable 

-MY OPINION:-

In this answer the etiology of the patient's problem is COPD due to conseqeunce of using chulha but I think that the problem is also with allergy while she is working in the paddy fields. The patient is suffering from the shortness of breathing from long time due to the inhalation of smoke and that caused damage to the lungs,thus the patient is susceptable to the lung infections.

 In this link, the evaluation of symptomatology was explained well. Pharmacological and Non pharmacological interventions were mentioned but not in a detailed manner. The placebo effect was also not explained properly. the overall case and the answers to the questions could have been explained properly.


CASE 8:

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

Diagnosis:Mylopathy hand

MY OPINION:-

The symptomatology has been very well explained with the help of a hand-drawn diagram, the etiology is very well supported with the help of a flowchart that appeals to the reader each subquestion has been made visible which enhances the readability of the document

Each pharmacological intervention has been explained in-depth with comprehensive language



CASE 9:-https://02shishirareddy.blogspot.com/

 Diagnosis : Alcohol induced dementia 

Review : Causes for electrolyte imbalance: 

                       Respiratory acidosis with metabolic alkalosis(due to renal compensation) in AECOPD patientswith chronic hypercapnia is the usual cause ofhypochloremia in these patient Commoncauses ofderanged serum sodium levels include hyperglycemia, use of thiazides or nonsteroidal anti-inflammatory drugs, congestive cardiac failure, chronic renal failure, and low dietary salt intake.

 Common causes of hypokalemia include diarrhea, laxative abuse, vomiting, certain diuretics, drugs like insulin, β2agonists, and theophylline.20 Thus, COPD patients per

se are predisposed to electrolyte imbalance. In turn electrolyte imbalance can cause respiratory muscle weakness, cardiac arrhythmia, low cardiac output. 

                    Thus the presence of electrolyte imbalance leads to significantly poor outcome among COPD patients.It is very interesting to know about the acidosis and very happy to read and get the knowledge about respiratory acidosis .it is really very helpful .

MY OPINION:-

The history of present and past illness is coherent and well established. The videos are great for understanding the case. The case sheet has captured all the relevant data in the right order. Correct terminology was used. The reports of all the lab investigations conducted were given. The pharmacological intervention was elaborate and explained well. 

The symptomatology with anatomical localization and primary etiology was explained very well. The explanation was done with help of diagrams which made it easier to understand. The treatment part was also explained with all the drugs and injections that were given to the patient. The causes that are explained for acute exacerbation and for electrolyte imbalance were appropriate. At last all the questions were answered and case was handled well.


Question 2-4: 


Patient centered data around the theme of renal failure patients with AKI, CKD and acute on CKD, 
captured by students from 2016 and 2019 batch in the links below:

Patients with low back ache and renal failure :

1. AKI :


A better presentation of the log could have been

Depicting the trends of investigations

Which would make it easier for the person reading to comprehend the data presented.

When typing the values normal range also to be mentioned so as to make it easier for the reader to understand better.


2. Acute on CKD :


All the history is presented well
Clinical images could have been shared
And trends of investigations could have been depicted to make reading easier and simple to compare
Fever chart should have been shared


3. CKD :


Detailed way of history taking but
Clinical images could have been shared
And trends of investigations could have been depicted to make reading easier and simple to compare
Fever chart should have been shared


4.Patient with coma and renal failure  :


Excellent presentation
But MRI images should have been put instead of the printed report



Perfect case presentation
Very well done



All have been well presented
With detailed history and examination



Clinical Images could have been shared along with fever chart
A more detailed history could have been taken


Q2) Share the link to your own case report of a patient that you connected with and engaged while capturing his her sequential life events before and after the illness and clinical and investigational images along with your discussion of that case. 

My blog:-
1.

2.


Q 5) Testing scholarship competency in  

logging reflective observations on your concrete experiences of this last month : (10 marks) 


Over all it has been a good learning experience of how to log the patient data and in detailed presentation of the cases

Hands on experience regarding sample collection

Inserting and removing foleys and ryles

Drawing blood

Connecting IV fluids

Starting a dialysis session

And more about the diagnosis and management of the cases

Some of my learning points that I noted






Link to one of my presentations:-


https://youtu.be/6GR6ysmkIpM




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