General Medicine Assignment
Monthly Online Summative Assessment
July 03, 2021
Tejomayi Algubelli
Roll no: 130
General Medicine assignment
Question 1
1. Pulmonology
Case: https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html
A 55-year-old female with chief complaints of shortness of breath, pedal oedema and face puffiness.
This is a case of acute exacerbation of COPD associated with right heart failure and bronchiectasis. After investigations were done, she was diagnosed with right heart failure ; because of low oxygen levels due to COPD. This also leads to renal failure causing the pedal edema and facial puffiness. Shortness of breath seems to be caused by bronchiectasis which is the thickening of bronchi. Required medication was given to alleviate the symptoms such as antibiotics, diuretics and steroids.
2. Neurology
A 55 year old male with seizures. This is a case of stroke which causes brain injury and results in the formation of scar tissue which disturbs the electrical activity in the brain leading to a seizure. The seizures are accompanied by tremors on the left leg and eye rolling. The seizures are due to a stroke which occurred five years before during an accident where the patient sustained trauma to the head. The patient was treated with medication to control the seizures and released with a prescription for after care.
3. Cardiology
A patient with acute myocardial infarction with a known case of hypertension and type 2 diabetes. It can be concluded that his atherosclerosis is the main cause along with the two risk factors. It is caused due to the build up of fat in the vessels. The patient was given asprin to prevent thrombosis and the treatment angioplasty was suggested to remove the atherosclerosis on the vessels.
4. Gastrology
The case is 40 years old lady with dysphasia and cough. The physical findings showed the presence of a trachea esophageal fistula. Abdominal distention may occur secondary to air in the stomach. Patients may get recurrent infections due to immune reconstitution inflammatory syndrome. She will be prone to opportunistic infections.
5. Neurology
52 year old male with cerebellar ataxia.It is a cerebellar infarct which is can be because of an ischemic stroke
So the location is in cerebellar blood vessels mostly in the arteries. The patient is hypertensive and high blood pressure is an important risk factor for stroke.
6. Neurology
The case is a 50 year old with cervical myelopathy. It could be due to cortical vein thrombosis. She was administered antiepileptic drugs which have seizure free periods as the drug effects wanes off the seizures appear again or when we withdraww them seizures appear again.
7. Cardiology
This is a case of acute coronary syndrome in patient with diabetes mellitus and past history of TB. She presented with sweating and ECG showed characteristics for an NSTEMI that are depressed ST wave, no progression of Q wave. Medication was given and a PCI was recommended. It is coronary angioplasty for treating cardiac diseases.
8. Cardiology
This is the case of a 72 year old patient with pedal edema and shortness of breath and decreased urinary output. Reason can be diabetes as Diabetic patients have an increased risk of developing heart failure because of the abnormal cardiac handling of glucose and free fatty acids (FFAs), and because of the effect of the metabolic derangements of diabetes on the cardiovascular system.
9. Gastrology
33 year old man with pancreatitis, pseudo cyst and left broncho pleural fistula. The acute pancreatitis is due to activation of pancreatic enzymes due to consumption of alcohol which cause cell injury and lesions. The patient is given antibiotics, and thiamine to maintain normal health of pancreatic cells.
10. Hepatology
A case of liver abscess in a 55 year old male who came in with complaints of pain in abdomen and decreased appetite. The patient is a chronic alcoholic. Liver aspiration was done and the treatment was given as fluids, antibiotics. The patient has routine check ups to monitor the situation.
Question 2
I have not gotten the chance to make a case report.
Question 3 and 4
This is a case of hypertensive nephropathy with uremic encephalopathy. The patient has a history of hypertension and chronic kidney disease and came with the complaint of fever, pedal edema and shortness of breath.
Appetite:Normal
Diet: Mixed
Sleep: Adequate
Bowels:Regular
Micturition:Normal
General examination- Patient is Conscious, Cohererent, Co-operative. He is Drowsy but Arousable(Hypo, delayed response to commands). Moderately built, nourished.
Treatment-
Patient is given intravenous fluids and LASIX injections to treat symptoms of fluid retention. Nodosis tablet is also administered to the patient to correct acid base imbalances.
Question 5
This last month in the general medicine postings has been an eye opening experience in terms of learning patient care and clinical cases. This is not only the first time we’ve been able to learn from the interns and doctors but also a the first time he have been able to see the inner workings of a hospital. It has become a valuable source of learning in these otherwise dull times. We have learnt how to take patient history, make a case report and monitor a patient. It’s all thanks to the efforts of the general medicine department in passing along their knowledge and bridging the gap between classroom and clinical knowledge.
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