general medicine assignment

 

 General medicine monthly online summative assesment

Moovika Reddy Siddenki

roll no:84

General medicine assignment(3rd sem)

 

QUESTION-1

1.PULMONOLOGY

REVIEW:https://31nehareddy.blogspot.com/?m=1

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

This is the case of acute exacerbation of COPD associated with right heart failure and bronchiectasis .she has been presented with pedal edema and facial puffiness. after investigation were done it can be seen that the low oxygen levels  due to COPD caused hypertension in the lungs. this increased the strain on the right heart leading to its failure. using rifampicin might have led to her facial puffiness. required medication for treating the symptoms was given like diuretics and antibiotics. chest physiotherapy was also recommended to prevent the collapse of lungs. monitoring the patient's vitals was also done in order to prevent further complications.

 

2.NEUROLOGY

REVIEW:https://divyaraju266.blogspot.com/

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

This is the case of cerebellar ataxia. symptoms include slurring of speech and deviation of mouth. the probable cause might be due to the presence of cerebellar infarct in the cerebella vessels. patient was asymptomatic at first but after consumption of alcohol he started presented these symptoms so i think that drinking alcohol led to hypertension leading to stroke. suitable medicines like tab vertin and tab ecosprin were recommended in order to prevent the clot formation in his blood vessels.

3. CARDIOLOGY

REVIEW:https://divyaraju266.blogspot.com/

CASE:https://bhavaniv.blogspot.com/2021/05/case-discussion-on-myocardial-infarction.html?m=1

This is a case of acute myocardial infarction. patient presented symptoms like chest pain, and profuse sweating. patient is a known case of type 2 diabetes and hypertension. it can be observed  that deposition of lipids and fats in the blood vessels of the heart led to obstruction of the blood vessels supplying the heart leading to ischemia. risk factors include diabetes and hypertension due to which mobilization of fats and lipids increases . aspirin was given to prevent thrombosis.

 

4.GASTROLOGY

REVIEW:https://divyaraju266.blogspot.com/

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

This is a case of dysphagia or could be tracheoesophageal fistula. it can be observed that patient has already suffered for bring RVD positive. she is in an immuno compromised state and might be susceptible to immune reconstruction inflammatory syndrome in which they present hyper inflammatory responses.

 

5.HEPATOLOGY

REVIEW:https://divyaraju266.blogspot.com/

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

This is a case of liver abscess. consumption of local alcohol might have lead to liver abscess. decreased movements in the right upper quadrant are observed this might tell us that the right lobe of liver was affected. this is due to fact that right lobe has more blood supply which includes portal vessels. local alcohol contains many microorganisms which might have infected the blood leading to liver abscess.

 

6.GASTROLOGY

REVIEW:https://divyaraju266.blogspot.com/

CASE:https://nehae-logs.blogspot.com/2021/05/case-discussion-on-25-year-old-male.html

This a a case of epigastric pain. symptoms include severe abdominal pain ,vomiting and shortness of breath. tenderness was observed around umbilical regions and decreased breathing sounds were heard probably due to pleural effusion. 24 hour urine protein sample test was recommended.

 

7.GASTROLOGY

REVIEW:https://divyaraju266.blogspot.com/

CASE:https://63konakanchihyndavi.blogspot.com/2021/05/case-discussion-on-pancreatitis-with.html

This is a case of pancreatitis. this might be due to the obstruction of the duct system of the pancreas. patient had history of alcohol consumption which might have led to the injury of acinar cells of the pancreas leading to pancreatitis. medicines like pantop were recommended to decrease acid secretion and prevent further complications .

 

8.CARDIOLOGY

REVIEW:https://santhoshdarimedi.blogspot.com/

CASE:https://daddalavineeshachowdary.blogspot.com/2021/05/67-year-old-patient-with-acute-coronary.html?m=1

This is a case of acute coronary syndrome. patient had episodes of heart burn. i think there must have been a rupture of plaque or coronary vessels might have been occluded leading to acute coronary syndrome. percutaneous coronary intervention was  suggested in which a small stent like structure will be placed in the damaged blood vessels in order to open them and ensure that the blood supply to heart is not interrupted.

 

9.CARDIOLOGY

REVIEW:https://dthanmai27.blogspot.com/

CASE:https://preityarlagadda.blogspot.com/2021/05/biatrial-thrombus-in-52yr-old-male.html

This is a case of atrial fibrillation and biatrial thrombosis. patent is a known patient of hypertension which might have let to the formation of thrombus. due to the formation of thrombus cardiac output was low leading to decreased GFR leading to the increased action of renin and aldosterone . increased aldosterone leads to sodium retention . this explains the puffiness of her face .dytor was recommended as it has antagonistic actions against aldosterone.

 

10.NEUROLOGY 

REVIEW:https://divyaraju266.blogspot.com/

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

This is a case of altered sensorium .patient presented with the symptoms of short term memory loss and seizures and patient has a known history of type 2 diabetes. he also has a history of alcohol consumption and cigarette smoking. alcohol contains ethanol which is a depressant of central nervous system. this explains why he has altered sensorium because sudden with drawl form alcohol leads to sensitization of GABA  receptors.

 

QUESTION 2

I have not gotten a chance to make a case report yet.

 

QUESTION 3 and 4

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

This is a case of hypertensive nephropathy.

symptoms include altered sensorium ,shortness of breath, lethargy .patient has a known history of hypertension and chronic kidney disease. his creatinine levels were high(11-14.8). patient was also complaining of back and neck pain.

general examination of the patient tells us that pallor is present.

in systemic examination of the patient it can be inferred that dyspnoea is present which means patient is suffering from breathing difficulties and he is hypoactive.

treatment-lasix is given to the patient. it helps in decreasing the hypertension and also acts as a diuretic and increases production of urine which further decreases hypertension.

sodium bicarbonate is also given to adjust the blood pressure and it also inhibits the angiotensin converting enzyme therefore prevents the increase in blood pressure by decreasing the absorption the water.

 

 

QUESTION 5

 

online clinical postings have been little challenging for all of us but our general medicine department was very helpful. these interactive lectures were very encouraging. i have learnt many new things about the subject. all the professors and interns have been doing their best to pass on their knowledge to us and were helping us to apply our knowledge in these clinical cases .i would also like to thank our HOD of general medicine ,Dr.Rakesh Biswas for giving me this opportunity.