General Medicine Monthly Assessment-1

Roll no:128

I have been given the following assignment in an attempt to read,

comprehend, analyze, reflect upon and discuss captured patient centered data.

Question 1:Analyse answers of ten students of one particular case. Assess it with  quantitative marking and highlight the qualitative aspects of the answer.

LINK:https://generalmedicinedepartment.blogspot.com/2021/06/bimonthly-formative-and-summative_19.html?m=1

Answer:

CASE STUDY

NEUROLOGY CASE

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

LINK 1: https://caseopinionsbyrollno05.blogspot.com/2021/05/medicine-blended-assignment-may-2021.html

review score :8/10 

A very detailed answer has been presented for every question mentioned. A very simple style of language and writing has been adopted.

Mode of action of every drug in the treatment plan has been well presented along with its physiological importance .

Patient's  history of illness has not been presented in terms of event timeline. 

LINK 2: https://csravanthi.blogspot.com/2021/05/online-blended-bimonthly-assignment.html

review score: 7/10

The content has been written in a clear font style.

The answers have been presented directly without the appropriate questions alongside. Not a very detailed solution is mentioned.

LINK 3: https://saichennuru.blogspot.com/2021/05/online-blended-medicine-assignment.html

review score:8/10

The basic biochemical aspects have been included while mentioning about thiamine deficiency manifestation such as its importance etc. Alcohol withdrawal Timeline along with a relevant diagram has been also added to e log.. 

LINK 4: https://divyaraju266.blogspot.com/2021/05/answers.html 

review score : 9/10

The answers have been presented briefly along with a clear flowchart . A very comprehensive style of writing and language has been adopted.

Overall, it is well presented . 

 LINK 5: https://laharika29.blogspot.com/2021/05/medicine-assignment_31.html

 review score: 7/10

Answers have been presented in brief manner .Text has been presented in a very basic font style .

Flowcharts, Appropriate diagrams can be added for better understanding of the case.  

Question 3:  Critical appraisal on presentation of the case [includes diagnosis given, Investigations done].

MEDICINE CASE DISCUSSION -CVS CASE STUDY 

[STUDENT REVIEW]

PATIENT DETAILS :

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

Positive aspects of the case presentation :

*The presenting illness is well highlighted and presented in a simple language . 

*The history presentation is very comprehensive and presented in a orderly manner.

*The systemic examination is pictorially presented for better understanding of the case .

*A very detailed video presentation of  2D Echo of the patient has been attached to the E-log.

 

Points that are be corrected :

*The pictures of biochemical investigations can be more clear.

*The date and time of patient's entry into the hospital and  time of death has not been mentioned.

*Reasons for hyperthyroidism with a past history of hypothyroidism for 5 years could have          been discussed in the e-log.  

*Post mortem report can be attached.

Question 4:Explain the plan of treatment with appropriate reasons.

PATIENT DETAILS:

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

DIAGNOSIS: HFrEF with Atrial fibrillation? IHD (Heart failiure with reduced ejection fraction with Atrial fibrillation to? Ischemic Heart Disease)

TREATMENT :

 Inj. Amiodarone 150 mgIV stat (2 doses)

 Inj. Amiodarone infusion

 1mg/min till 6hr f/b 0.5 mg/min for next 18 hours

 Inj. Clexane 40mg Sc OD

EFFICACY OF TREAMENT :

Pharmacological reference : They are classified as Agents widening Action Potential [Class III Antiarrhythamic drugs].

                                                                        

*Prolongs Action potential duration and Q-T interval attributable to block of myocardial delayed rectifier K+ channels.

*Preferentially blocks inactivated Na+ channels (like lidocaine) with relatively rapid rate of channel recovery ;more effective in depressing conduction in cells that are partially depolarized or have longer action potential duration.

*Partially inhibits myocardial Ca+ channels.

*Has non competitive beta adrenergic blocking property and alters thyroid function.

NOTE :Despite prolongation of action potential duration ,the arrhythmia provoking potential of amiodarone is low, probably because it does not exhibit 'reverse use-dependence' of APD prolongation and a uniform action on this modality, or because of its multiple antiarrhythmic mechanisms.

Unlike other class III drugs, Amiodarone is independent of Rate Of Activation   

OTHER REFERNCES :

*https://pubmed.ncbi.nlm.nih.gov/25181386/

*https://pubmed.ncbi.nlm.nih.gov/15872201/

Question 5: Testing scholarship competency in logging reflective observations on your concrete experiences of this last month.  

 MY EXPERIENCE ON CASESTUDY IN THE  MONTH OF JUNE

Being the first month of  my clinical posting, I had great experience with the subject. Though being an online platform, it was a virtual treat interacting with the Senior most faculties, Postgraduates and interns of the department along with live sessions where we had an opportunity to interact with patients for better understanding of there presenting illness and got fine teaching in the Art of history taking under guidance of Faculties, Postgraduates and interns team of General Medicine.

The department also took an initiative of  teaching students by process of active learning where students came forward with suggestions in regard with treatment planning, and raise questions about different aspects of history taking procedure which instilled in us deeper understanding of the diagnosis and its clinical importance.

 Feedback Sessions had also been conducted and suggested feedbacks have been implemented for a easy and effective learning .

Overall its been a wonderful experience till now .

Thank you