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 significant respiratory acidosis  • Reference- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893753/ 2) CPAP for pneumonia treatment  • The Cpap does not treat pneumonia directly but can reduce the work of breathing often seen with pneumonia. In most cases rpneumonia is unilateral and can interfere with gas e
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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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General Medicine Assignment

Monthly Online Summative Assessment  July 03, 2021 Tejomayi Algubelli  Roll no: 130 General Medicine assignment  Question 1  1. Pulmonology  Review:  https://divyaraju266.blogspot.com/2021/05/answers.html 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  Review:  https://divyaraju266.blogspot.com/2021/05/answers.html Case:  https://ris
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