MEDICINE BLENDED ASSIGNMENT AUGUST 2021
GENERAL MEDICINE DEPARTMENT - JUNE 2021 BIMONTHLY BLENDED ASSESSMENT .
M.Koushiki rn.79
3rd sem 2019 batch
The following blog is an assignment that was given to us - for evaluation of our skills over the last month
Max Marks: 100 (5 questions in total and 20 marks for each answer)
This is the link of the questions asked regarding the assignment:
Question 1:(Testing peer review competency in the active reader of this assignment) :
Please go through the long and short cases in the first link shared above and provide your critical appraisal of the captured data in terms of completeness, correctness and ability to provide useful leads to analyze the diagnostic and therapeutic uncertainties around the cases shared.
Please provide your peer review assessment on not only the the student's written case report but also the reading of the cases followed by the question answer session linked above in the video and share your thoughts around each answer by the student along with your qualitative insights into what was good or bad about the answer.
LONG CASE
COMPLETENESS:
The case log has details of the patient's complaints and history of present illness , past illness , all the investigations are shown with images .
The timeline of symtomatology and Anatomical localization are decsribed well.
History analysis in approching the patients problems is done
Also the localization of the acute problem with which the patient presented and localization of the chronic problem associated withe sever join pains is well described .
The differential diagnosis also done
I appreciate the diagnostic approach given in the blog, it paid attention to all the possibilities, ruled out one by one and arrived to a final diagnosis.
CORRECTNESS:
The data provided is correct
.
USEFUL LEADS TO ANALYZE THE DIAGNOSTIC AND THERAPEUTIC UNCERTAINTIES :
Someuseful leads are provided in the blog to analyze the diagnostic and therapeutic uncertainties of the case . Many useful leads are taken and described in the process of diagnostic approach.
SHORT CASE: 1
COMPLETENESS:
The case is complete with all necessary data but the complete treatment data is not provided and his updates also.
CORRECTNESS:
The data provided is correct
SHORT CASE: 2
COMPLETENESS:
The elog was complete
It included chief complaints , history of presenting illness , history of past illness , medical / surgical history , personal history , family history , social & education history , immunization history.
CORRECTNESS :
The data provided is correct
SHORT CASE:3
COMPLETENESS:
The case is complete with all necessary data
The case log has details of the patient's complaints and history of present illness , past illness , all the investigations are shown with images .
The timeline of symtomatology and Anatomical localization are decsribed well.
CORRECTNESS :
The data provided is correct
Question 2:
Testing scholarship competency of the examinees ( ability to read comprehend, analyze, reflect upon and discuss captured patient centered data):
Please analyze the above linked long and short cases patient data by first preparing a problem list for each patient in order of perceived priority (based on the shared data) and then discuss the diagnostic and therapeutic uncertainty around solving those problems.
LONG CASE
SHORT CASE 2
All the investigations lead to the diagnosis of the case and better treatment of the patient. Hence, no diagnostic uncertainties were found.
Question 3
Testing competency in "Evidence based medicine": Include the review of literature around sensitivity and specificity of the diagnostic interventions mentioned and same around efficacy of the therapeutic interventions mentioned for each patient.
LONG CASE
INVESTIGATIONS:
•X-Ray of hands and wrists
•Chest X-Ray - Right heart border showed mildly dilated rt. atrium .
•The Left heart border shows a prominent aortic knuckle .
•ECG done
•Blood tests done
•24 hr Urinary protein : 1500mg
•24 hr Creatinine: 0.8
DIAGNOSIS :
Acute Glomerulonephritis, likely due to Secondary Amyloidosis due to Chronic Poorly Treated Seronegative Erosive Rheumatoid Arthritis.
Dilutional Hyponatremia secondary to Anasarca due to Glomerulonephritis
Hyperuricemia likely due to decreased Uric Acid Excretion Precipitating Gouty Arthritis
Anemia of Chronic Disease secondary to Poorly Treated Rheumatoid Arthritis.
The diagnostic approach is appropriate
Features supporting the diagnosis of glomerulonephritis were mentioned accurately.
SHORT CASE 1:
INVESTIGATIONS:
•ECG- Showed sinus tachycardia , with pseudo infarct pattern in lead I and aVL with dagger q waves in same leads ; also showed LVH .2 D •ECHO: Grade II diastolic dysfunction
DIAGNOSIS :
Idiopathic Parkinson's Disease Stage 1 with denovo HTN.
Multiple System Atrophy - Parkinsonian Type (MSA-P).
The diagnostic approach is appropriate
SHORT CASE 2:
INVESTIGATIONS:
•CUE Albumin - +1
•GRBS - 139mg/dl
•CBP
•TLC
•LFT - TB - 1.03
Albumin - 3.9
•RFT- urea - 22 Serum creatinine - 0.6Electrolytes -NA - 136 , K+ - 4 , Cl- - 98
•ECG - Sinus tachycardia LVH present
•USG- Abdomen
DIAGNOSIS :
IATROGENIC CUSHINGS SYNDROME Secondary to TOPICAL CLOBETASOL APPLICATION all over body for approximately one year.
TINEA CORPORIS
DENOVO HTN
The diagnostic approach is appropriate
Question 4
Testing competency in patient data capture and representation through ethical case reporting/case presentation with informed consent :
Share the link to your own case report this month of a patient that you connected with and engaged while capturing his her sequential life events before and after the illness and clinical and investigational images along with your discussion of that case.
Question 5
Testing scholarship competency in
logging reflective observations on your concrete experiences of this last month
Reflective logging of one's own experiences is a vital tool toward competency development in medical education and research.
I do agree this . The General medicine department has done quite a good work in making us understand the subject. For every clinical case, they have guided us on how to study and analyze the case. I have learned how to capture patient-centered data for diagnosing the disease.
Its being long still we didn't get a chance to attend clinical postings and observe and learn get interacted with patient.
I hope soon we able to attend the clinical postings .
THANK YOU SIR
THE END OF ASSIGNMENT ______________
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