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.
Q1) Review the last assignment of your adjacent roll number.Mention the positive and negative aspects or comment on the relevancy of the answers.
LINK:
POSITIVE ASPECTS:
•The questions have been answered to the point.
•Have adopted a simple font style thus it is easier to read .
•Overall the answers have been presented in brief and comprehensive manner.
POINTS THAT CAN BE CONSIDERED:
•Could have presented answers in question and answer format .
•The answers can be split into appropriate subheadings such as:
#Diagnosis
#Treatment plan
#Efficacy of treatment
•Respective links to the case details can be added separately for each answer for easy reference.
Q 2) Post the link for your E-log presented this month.
Below is the link for the elog:
Q3)Analyse answers presented in the following links presented below.
1) LINK:
POSITIVE ASPECTS:
•The E-log is overall comprehensive.
•Point wise presentation.
•The report has been updated regularly and has been presented in a proper sequence.
•Normal range has been mentioned along with biochemical investigation reports.
POINTS THAT CAN BE CONSIDERED:
•Date of admission and discharge summary can be mentioned .
2)LINK:
POSITIVE ASPECTS:
•The entire E-log has been presented in a proper order.
•The investigations and treatment plan has been presented in date wise order.
POINTS THAT CAN BE CONSIDERED: •Personal,family and drug history has to be mentioned.
•Date of admission and discharge summary can be mentioned.
3)LINK:
POSITIVE ASPECTS:
•History presented in a chronological order along with clear pictures of investigations reports.
•Detailed treatment plan.
•Normal reference range has been mentioned along with biochemical investigations.
POINTS THAT CAN BE CONSIDERED: •Date of admission and discharge summary can be mentioned.
•The headings can be well contrasted from its respective content for better understanding.
4)LINK:
POSITIVE ASPECTS:
•Date of admission of patient has been mentioned.
•History of presenting illness has been written in a very simple language.
•Investigation report pictures have been very well displayed and explained in detail.
POINTS THAT CAN BE CONSIDERED:
•History and treatment plan can be presented in a chronological order.
5)LINK:
POSITIVE ASPECTS:
•Date of admission is mentioned.
•History taking is presented very clearly in an order.
•Discharge summary has been mentioned.
•Overall it is very comprehensive.
6)LINK:
POSITIVE ASPECTS:
•Date of admission is mentioned .
•Pictures of investigation report are very clear.
•History of presenting illness has been very well written.
•Important points have been highlighted.
POINTS THAT CAN BE CONSIDERED:
•Treatment plan could have been elaborated and can be presented according to date.
•Discharge summary is not mentioned.
7)LINK:
POSITIVE ASPECTS:
•Clinical investigations have been mentioned in detail along with date of investigation.
•Relevant articles links have been added.
POINTS THAT CAN BE CONSIDERED:
•Date of admission can be mentioned .
8)LINK:
POSITIVE ASPECTS:
•Detailed presentation of case report.
•Pictures of investigation report are very clear.
POINTS THAT CAN BE CONSIDERED:
•Past history could have been presented with more clarity.
•Treatment can be mentioned under a separate heading and not under history of present illness.
•Date of admission not mentioned.
9)LINK:
POSITIVE ASPECTS:
•Per abdominal examination has been elaborately presented.
•Pictures of investigation report are very clear.
POINTS THAT CAN BE CONSIDERED:
•Date of admission and discharge summary can be mentioned .
10)LINK:
POSITIVE ASPECTS:
•Overall very nice presentation.
•Treatment and biochemical investigations have been mentioned in chronological order.
POINTS THAT CAN BE CONSIDERED:
•Date of admission and discharge summary can be mentioned .
Q4)Assess the diagnosis, treatment plan and efficacy of the treatment presented in the following cases.
1)LINK TO CASE DETAILS:
DIAGNOSIS:
•Acute kidney injury( AKI) 2° to UTI, associated with Denovo - DM -2
•With Right heart failure
• K/C/O - HTN ( Not on Rx)
TREATMENT:
1)IVF -RL @ UO+ 30ml/hr NS
2)SALT RESTRICTION <2.4gm/day
3)INJ. TAZAR- 4.5gm IV/TID
|
2.25gm IV/ TID
4)INJ. PANTOP-40mg IV/OD
5)INJ. THIAMINE -1ampoule in 100ml NS/IV/TID
6)INJ. HAI S/C according to sliding scale(8AM - 2PM - 8PM).
7)SYP. LACTULOSE -15ml PO/TID[ To maintain stools less than or equal to 2].
8) GRBS- 6th Hourly
9) BP/PR/TEMP- 4th Hourly
10) I/O -CHARTING
ON 10/7/21:
1)IVF-RL @ UO+ 30ml/hr-NS
2)SALT RESTRICTION <2.4gm/day
3)INJ. TAZAR -2.25gm IV/ TID
4)INJ. PANTOP-40mg IV/OD
5)INJ. THIAMINE -1ampoule in 100ml NS IV/TID
6)TAB. PCM-500mg PO/ SOS
7)INJ. HAI S/C according to sliding scale(8AM - 2PM - 8PM).
8)GRBS- 6th Hourly
9) BP/PR/TEMP- 4th Hourly
10) I/O - CHARTING (STRICT)
11)T. ULTRACET-1/2 TAB PO/QID
2) LINK TO CASE DETAILS:
https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.ht
DIAGNOSIS:
DKA with AKI ( ? Pre renal) USG(25/06/21) - Pyelonephritis.
TREATMENT:
Day 1
Inj. NORAD 2amp in 50ml NS
Inj. PIPTAZ 2.25gm.
Inj. DOPAMINE 2amp in 50ml
Inj. HAI 1ml in 39ml NS
Day 2
Inj.HAI 1ml in 39mlNS
Inj. PIPTAZ 2.25gm.
Inj. CLEXANE 40gm.
Iv infusion NS RL @100ml/hr.
Day 3
Inj.HAI 1ml + 34ml NS
Inj. PIPTAZ 2.25gm
Iv infusion NS (urine output + 40ml/hr)
Inj. NORADRENALINE(2 amp+46ml NS)
Day 4,5 same as day 3
Day 6
Inj. PIPTAZ
Inj. LEVOFLOX
Inj. VANCOMYCIN
Day 7 and 8 same as day 6.
Day 9
Inj. MEROPENEM
Inj. LEVOFLOX
Inj.VANCOMYCIN
Day 10 and 11 same as day 9
Day 12
Inj. MEROPENEM
Inj. FOSFOMYCIN
Inj. CLEXANE
Day 13 and day 14 same treatment as of day 12 additionally Inj. LASIX was given.
3)LINK TO CASE DETAILS:
https://pallavi191.blogspot.com/2021/06/gm-cases_30.html?m=1
DIAGNOSIS:
INFECTIVE ENDOCARDITIS
WITH AV VEGETATIONS WITH MODERATE AS SEVERE AR
WITH AKI
WITH ?UREMIC ENCEPHALOPATHY ? SEPTIC ENCEPHALOPATHY
WITH ULCER OVER SOLE OF RIGHT LEG
WITH HYPOALBUMINEMIA ? ALCOHOLIC LIVER DISEASE
WITH ACUTE MULTIPLE INFARCTS IN BILATERAL CEREBRAL AND CEREBELLAR HEMISPHERES
TREATMENT:
Day 1:
1. Inj. Monocef 1gm IV/BD
2. Inj. Vancomycin 500mg IV/BD in 100ml NS over 1hr
3. Procto clysis enema
4. Inj. Pan 40 mg Iv/OD
5. Inj. Thiamine 200mg in 100ml NS /BD
6. Inj. HAI 6U S/C TID
Day 2&3:
Same treatment followed
Day 4:
Same treatment followed except Inj. Monocef.
Inj. Augmentin 1.2 gm IV/TID
Tab. Ecospirn 150mg PO/HS/SOS
Tab. Clopidogrel 75mg PO/HS/SOS
Tab. Atorvas 20mg PO/HS/OD added
4)LINK TO CASE DETAILS:
DIAGNOSIS:
Renal AKI secondary to urosepsis with b/l hydroureteronephrosis with K/C/O DM-type2 since 5 yrs with diabetic nephropathy with anemia secondary to CKD with grade 1 bedsore.
TREATMENT:
1)Injection PANTOP 40mg IV/OD
2)Injection PIPTAZ 4.5 stat and 2.25 gm IV/ TID
3)Injection LASIX 40mg IV/BD
4)Injection optineuron 1AMP in 100ml NS slow IV/OD
5)Injection NEDMOL 100ml IV/SOS
6)Tab PCM 650mg TID
7)Insulin Human actrapid - 16 IU/TID
5)LINK TO CASE DETAILS:
DIAGNOSIS:
ACUTE ON CHRONIC LVF
HFrEF SECONDARY TO CAD
CKD- STAGE 4
RENOCARDIAC 4
TREATMENT:
DAY-1
TAB. BISOPROLOL 5mg OD
TAB. NITROHART 20/37.5mg 1/2 T/D
TAB NICARDIA XL 30mg OD
TAB. GLICIAZIDE 80mg BD
TAB. NODOSIS 500 mg TD
Cap. BIO-D3 OD
Cap. GEMSOLINE OD
TAB. ECOSPRIN-AV 150/20mg OD
TAB.LASIX 40mg BD
SYP. LACTULOSE 15ml
TAB. NITROHART 20/37.5mg 1/2 T/D
TAB NICARDIA XL 30mg OD
TAB. GLICIAZIDE 80mg BD
TAB. NODOSIS 500 mg TD
Cap. BIO-D3 OD
Cap. GEMSOLINE OD
TAB. ECOSPRIN-AV 150/20mg OD
TAB.LASIX 40mg BD
SYP. LACTULOSE 15ml
DAY-2
FLUID RESTRICTION <1.5 L /DAY
SALT RESTRICTION <2 G DAY
TAB BISOPROLOL 5MG OD
TAB NICARDIA XL 30mg OD
TAB. GLICIAZIDE 80mg BD
TAB. NODOSIS 500 mg TD
Cap. BIO-D3 OD
Cap. GEMSOLINE OD
TAB. ECOSPRIN-AV 150/20mg OD
TAB.LASIX 40mg BD
SYP. LACTULOSE 15ml
DAY-3
FLUID RESTRICTION <1.5 L/DAY
SALT RESTRICTION <2g/DAY
TAB BISOPROLOL 5MG OD
TAB GLICIAZIDE 80 MG BD
TAB NODOSIS 500 MG TID
CAP BIO - D3 OD
CAP GEMSOLINE
TAB. ECOSPRIN-AV 150/20mg OD
TAB.LASIX 40mg BD
TAB HYDALIZINE 25 MG PO/TID
SYP CREMMAFIN PLUS 15 ML/TID
Q5)Testing scholarship competency in logging reflective observations on your concrete experiences of this last month.
Link to case details:
The patient was diagnosed with chronic pancreatitis with rt retroperitoneal fluid collection.
My case experience
It was a great opportunity to understand the methodology of procuring case history from patient,its clinical correlation and its importance.The case helped in vertical integration of basic science concepts as well.The case discussion also helped to understand the steps involved in concluding from provisional diagnosis to final diagnosis.We got an idea regarding the physical examination of the patient affected by pancreatitis.
Thus overall it was a wonderful experience.
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