Medicine Blended Assignment :
July 25 , 2021
General medicine bimonthly blended assignment :
Hi, I'm K.Lahari , a medical student (3rd sem).
I have been given the
following cases to solve in an attmept to understand the topic of 'Patient
clinical data analysis' to develop my competency in reading and comprehending
clinical data including history, clinical findings, investigations and diagnosis
and coem up with a treatment plan
This is the link regarding assessment:
medicinedepartment.blogspot.com/2021/07/medicine-paper-for-july-2021-bimonthly.html?m=1
Question 1 : peer review
link :
https://srinijakarnekanti63.blogspot.com/2021/07/general-medicine-assessment.html?m=1
~Here is my review:
Her review was
genuine on the cases that she selected and she gave the summary of the each case
and it was very concise and easy to understand and the information was well presented.
Question 2 : Link to my blog
https://laharikantoju.blogspot.com/2021/07/58-year-old-male-patient-elog-lahari.html
Question 3: Testing peer review competency of the examinees
Case-1 : Acute on CKD
link to the case :
~Here is my review:
The general examination and history of the patient was very
concise and easy to understand and biochemical
reports, diagnostic imaging was shown very clearly the information was well presented and I can understand hardwork behind this work .
Case-2 : CKD
link to the case :
~Here is my review:
The case was presented in
a easy and more information was given , a
thorough history taking has been done and the case is well explained using all
the pictures of investigations and reports.
Case-3: Patient with coma and renal failure
link to the cases :
~Here is my review:
Both the elogs were well
organized and the placement of images and videos of the patient played a key
role to understanding the cases , investigations
were done and treatment was given accordingly, it is really awesome work and I can understand
hardwork behind this work , the
information was well presented.
Case-4: Patients with AKI
link to the case :
~Here is my review:
It is a case of Alcoholic Hepatitis and aki sec to gastroenteritis , history taking
and the way of presenting the case with the required images and information is
so neat and very easy to understand
Case-5 : Patients with acute on CKD
Link to the cases :
~Here is my review:
Chronic kidney disease (CKD) refers to all 5 stages of kidney damage , from
very mild damage in Stage 1 to complete kidney failure in Stage 5 , in
the above cases patient
history was well written and easy to comprehend , the use of multiple images of
patient was very helpful and made the cases more interesting to read and diagnostic
imaging was shown very clearly. The
chronogological order of the progression was well placed and treatment plan was
easy to comprehend. I really like the way they differentiated the subjects accordingly.very
lucky to come across these blogs
Case-6: Patients with AKI
~Here is my review:
These are the cases of Acute Kidney Injury secondary to Urosepsis and pancreatitis
in a chronic alcoholic with AkI , the cases were presented in a easy and more information was given , a thorough history taking has been done and the
case is well explained using all the pictures of investigations and reports.the
symptomatology was well explained and presented ,all the images necessary and the various investigations were supported by the
image ,were provided properly the detailed information is given
with the indications and contraindication.
Question 4:
-Acute kidney injury (AKI):
AKI causes a build-up of waste products in your blood and makes it hard for your kidneys to keep the right balance of fluid in your body. AKI can also affect other organs such as the brain, heart, and lungs. Acute kidney injury is common in patients who are in the hospital, in intensive care units, and especially in older adults.
Signs and symptoms of acute kidney injury differ depending on the cause and may include:
- Too little urine leaving the body
- Swelling in legs, ankles, and around the eyes
- Fatigue or tiredness
- Shortness of breath
- Confusion
- Nausea
- Seizures or coma in severe cases
- Chest pain or pressure
Treatment for AKI :
-usually requires you to stay in a hospital. Most people with acute kidney injury are already in the hospital for another reason.
In more serious cases, dialysis may be needed to help replace kidney function until your kidneys recover. The main goal of your healthcare provider is to treat what is causing your acute kidney injury.
The best ways to lower your chances of having kidney damage and to save kidney function are to prevent acute kidney injury or to find and treat it as early as possible.
-Chronic kidney disease (CKD):
characterized by a gradual loss of kidney function over time.
- Heart disease is the major cause of death for all people with CKD.
- Glomerular filtration rate (GFR) is the best estimate of kidney function.
- Hypertension causes CKD and CKD causes hypertension.
- Persistent proteinuria (protein in the urine) means CKD is present.
- High risk groups include those with diabetes, hypertension and family history of kidney failure. The two main causes of chronic kidney disease are diabetes and high blood pressure which are responsible for up to two-thirds of the cases
symptoms:
- feel more tired and have less energy
- have trouble concentrating
- have a poor appetite
- have trouble sleeping
- have muscle cramping at night
- have swollen feet and ankles
- have puffiness around your eyes, especially in the morning
- have dry, itchy skin
- need to urinate more often, especially at night.
Treatment:
-Damage to your kidneys is usually permanent. Although the damage cannot be fixed, you can take steps to keep your kidneys as healthy as possible for as long as possible. You may even be able to stop the damage from getting worse.
- Control your blood sugar if you have diabetes.
- Keep a healthy blood pressure.
- Follow a low-salt, low-fat diet.
- Exercise at least 30 minutes on most days of the week.
- Keep a healthy weight.
- Do not smoke or use tobacco.
- Limit alcohol.
- Talk to your doctor about medicines that can help protect your kidneys.
-Acute on Chronic Kidney Disease :
Patients with chronic kidney disease (CKD), as evidenced by a low eGFR or presence of proteinuria, are at higher risk for developing AKI, a condition known as acute on chronic renal failure (ACRF). CKD is a strong risk factor for cardiovascular events, and patients with CKD are at particular mortality risk if they develop ACRF.
The clinical features of ACRF are similar to those in patients with de novo AKI
Patients with ACRF can be profoundly acidemic (pH less than 7.1). In patients without severe volume overload, acidemia can be treated with intravenous sodium bicarbonate. In patients in whom sodium bicarbonate or similar base cannot be given, renal replacement therapy is indicated
Question 5:
Making a blog on a case is
very interesting and my pleasure to do and I am very glad that the hod sir and
the pg ,intern mams and sirs for guiding
us. This kind of learning is very good opportunity for us.
We are working in small groups, and it is helping to
communicate with each others and to gather useful information .Knowing and
writing about a case , helping improving ability to induce a deeper level of learning by inducing more critical thinking skills.
By Peer review , getting the feedback on our blog writing, will improve to do much
better
blog generally take the format of:
CHIEF COMPLAINTS:
HISTORY OF PRESENTING ILLNESS:
TREATMENT HISTORY:
PERSONAL HISTORY:
FAMILY HISTORY:
PHYSICAL EXAMINATION:
VITALS:
SYSTEMIC EXAMINATION
INVESTIGATIONS
And all..
And by writing the information under those above headings , makes us to knows about history taking , examinations and investigations to be done.
Thank you
K.Lahari
Roll no: 61
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