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July 2021 GENERAL MEDICINE BIMONTHLY ASSESSMENT

 Scholarship of integration in medical education and research, a tool to facilitate connections between different systems in healthcare. 

This assignment enables us to read,comprehend, integrate,analyze and discuss captured patient centered data at an undergraduate level. 

Questions for the assignment( linked here http://medicinedepartment.blogspot.com/2021/07/medicine-paper-for-july-2021-bimonthly.html?m=1)

Q1. Competency tested for peer to peer review and assessment.
I've gone through this blog for a peer review. (https://32srilekhachitti.blogspot.com/2021/07/bimonthly-blended-assessment-june-2019.html?m=1)
Her Reviews included cases related to pulmonology, neurology, nephrology, gastroenterology where her understanding of the case was also clearly stated.
Some reviews were rated higher as she found the diagrams, flowcharts, and links for further reference to be helpful.
Though the negatives were not mentioned, the positives were all clearly stated.
About the Critical appraisal of the captured patient data and analysis,she has written her understanding of the case in a clear manner.
The problem list could be formatted in a better way to provide a clear understanding.
Her views on offline postings were legitimate.

Q2. Case report of a patient.
( I didn't get a case to elog this month. However, will be doing this soon after getting a case)

Q3 and 4.Critical appraisal of captured patient data for the following cases of renal failure. Problem list and diagnostic uncertainties. 
Case1:-AKI Link to the case is below :

https://laharikantoju.blogspot.com/2021/07/58-year-old-male-patient-elog-lahari.html?m=1

Detailed history taking which is elaborate and relevant.
my analysis is of the case:
patient is suffering from burning micturition,chills,back pain and decreased output of urine.All these are symptoms of UTI and AKI.
This shows acute kidney injury, secondary to UTI.
Evidence of infection for diagnosing urinary tract infection:
Bacterial culture and sensitivity report shows presence of polymicrobial flora and plenty of pus cells in urine.

Diagnosis : AKI secondary to UTI, associated with Denovo - DM -2 
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 1AMP IN 100ml NS IV/TID

Case 2 :-Patient with acute on CKD Link to the case is below :

https://kavyasamudrala.blogspot.com/2021/05/medicine-case-discussion-this-is-online.html?m=1

Symptomatolgy and treatment was clearly stated.
By examination of urine sample as it contains pus cells it is diagnosed with pyuria, caused due to bacterial infection leading to urinary tract infection which leads to urosepsis.This causes burning micturition. Fever is due to infection.
This urosepsis leads to AKI(Acute kidney injury)
Diagnosis: Renal AKI secondary to urosepsis with b/L hydroureteronephrosis
Treatment: 
Injection PANTOP 40mg IV/OD
Injection PIPTAZ 4.5 stat and 2.25 gm IV/ TID
Injection LASIX 40mg IV/BD
Injection optineuron 1AMP in 100ml NS slow IV/OD

Q5. Testing Scholarship competency in logging reflective observations on experiences of this last  one month.
The last month has been new in terms of clinical exposure as we got a chance to be a part of an actual case for the first time. We learned how to take up and log a patient's history. With the clinical cases given to us, we are trying to integrate them to the best of our knowledge on current 3rd sem subjects. The online clinicals are although not relatively effective, the professors from their end and we from our end are trying to be productive






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