First Internal

General Medicine First Internals 

Tejomayi Algubelli 

Roll No 130 (2019 batch)
























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PRE FINAL OSCE

  1) Criteria for weaning patient off of ventilator?   -> Subjective assessment:      Adequate cough      No neuromuscular blocking agents       Absence of excessive trachea bronchial secretions       Reversal of underlying cause of respiratory failure         -> Objective assessment:      Stable cardiovascular status      Heart rate <140 beats/min      No active myocardial ischemia       Adequate heamoglobin level >8g/dL      Systolic blood pressure 90-160mmHg       -> Adequate oxygenation:       Tidal volume >5mL/kg       Vital capacity >10mL/kg       Proper Inspiratory effort        Respiratory rate <35/min       PaO2 >60mmHg, PCO2 <60mmHg       No signif...
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83 year old male with shortness of breath

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This is an a online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt 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 come up with diagnosis and treatment plan. ——————————————————— ————— - > Chief complaints: • Cough since 16 days • Fever since 14 days • Shortness of breath since 12 days -> History of Presenting illness: Patient was admitted to ICU on 20/11/23 ...
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