Formative assessment

 Bimonthly Blended Assessment for June 2021

03/07/2021 

I, B.Varshitha, roll no.21, student of 3rd semester was given the following formative assessment for bimonthly blended assessment for June, 2021.

This is the link regarding assessment: 

https://medicinedepartment.blogspot.com/2021/06/medicine-department-paper-for-june-2021.html?m=1


Question 1:

Case 1:

 https://soumyanadella128eloggm.blogspot.com/

What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patient's problem?


my review for the answer of this question:

In this answer the etiology of the patient's problem is COPD due to conseqeunce of using chulha but I think that the problem is also with allergy while she is working in the paddy fields. The patient is suffering from the shortness of breathing from long time due to the inhalation of smoke and that caused damage to the lungs,thus the patient is susceptable to the lung infections.



case-2:

https://aniganikavya06.blogspot.com/

what is the reason for giving thiamine in this patient?


my review for the answer of this question:

In this case the patient symptoms i.e altered mental status,involuntary eye movements,fainting related to Wernicke korsakoff syndrome and symptoms when not consuming alcohol i.e tremors,sleeep distribances,sweating are related to withdrawal syndrome. patient urea and creatine levels are also increased.

I agree with  the answer given and reason is accurate i.e chronic alcoholism can leads to thiamine deficiency and also mentioned about the functions of thiamine.And also mentioned the clinical manifestations of thiamine deficiency.




case 3:

https://bejugamomnivasguptha.blogspot.com/


What are the changes seen in ECG in case of hypokalemia and associated symptoms?


my review for the answer of this question:

In the case the investigations are all done and diagnosed as recurrent hypokalemia and cervical spondylosis. I think past history of the patient is very helpful.

In the answer it is mentioned about the changes seen in ECG and all the symptoms of hypokalemia that the patient had i.e arrhythmia, palpitations ,irregular bowel movements etc.



case:4 

https://budigesaikiran14.blogspot.com/


What are mechanism of action, indication and efficacy over placebo of each of the pharmacological and non pharmacological interventions used for this patient?


my review for the answer of this question:

In the answer it is given about the mechanisms and pharmacological intervention in detail that is appreciable



case:5

https://preethicheera.blogspot.com/?m=1


Does the patients history of alcoholism make him more susceptible to ischaemic or haemorrhagic type of stroke?

my review for the answer of this question:

I agree with the answer given because chronic alcoholism is the major contributor to hemorrhagic and ischemic shock and alcohol also promotes brain injury. 




case:6

https://saichennuru.blogspot.com/


What is the probable reason for Kidney injury in this Patient?


my review for the answer of this question:

In the answer all probable reasons for kidney injury is given due to chronic alcoholism. I agree that free radicals produced due to breakdown of alcohol cause tissue injury and increase inflammation that effects the function of the kidneys. Alcohol decreases the filtration capacity of kidneys to toxic substances

 

case:7

https://laharika29.blogspot.com/


Does his lipid profile has any role for his attack?


my review for the answer of this question:

I agree that the higher levels of serum HDL cholesterol lower the risk of subsequent ischemic stroke. HDL cholesterol is good cholesterol that transfers the fat from periphery to liver and decreases the risk of atherosclerosis.



case:8


https://31nehareddy.blogspot.com/?m=1


How does the pre-existing ILD determine the prognosis of this patient?


my review for the answer of this question:

I agree that COVID-19 infection has led to acute exacerbation of underlying intestinal lung disease.COVID can cause exacerbation of ILD symptoms such as dyspnea, decreasing levels of SpO2 further . And also due to ILD the prognosis of the patient is poor. ILD makes the oxygen more difficult to pass into the blood stream

 

case:9

https://33manogna.blogspot.com/

Could chronic alcoholism have aggravated the foot ulcer formation? If yes, how and why?


my review for the answer of this question:

In the answer it is mentioned only about importance of the oxygen supply to the wound but nutritional supply is also crucial for the healing of the wounds. Excessive alcohol consumption may cause nutritional deficiency and alcohol toxicity.This leads to poor wound healing.Alcohol impair the nutrient absorption by damaging the cells lining the stomach and intestine and inhibiting the transport of some nutrients.


case:10

https://gumudalavishal.blogspot.com/


What are the risk factors for atherosclerosis in this patient?


my review for the answer of this question:

I agree that the risk factor in the patient is hypertension because it impairs blood vessel's ability to relax and all the changes cause the artery clogging process. Other risk other of atherosclerosis  are high cholesterol levels, smoking, obesity, etc.






Question 2

case report





 Question 3 and 4


link shared on abdomen based case

https://casescape.blogspot.com/2021/06/acute-kidney-injury-secondary-to.html?m=1



A 60 yr old female patient suffering from bilateral and pitting type of pedal edema, decreased urine output, burning micturation and fever from 10 days. She is known case of diabeties mellits. On general examination she is pallor, pulse rate and blood pressure is high.In systemic examination CVS, respirational and abdominal systems seems normal.

In the investigations -albumin levels are more than normal in urine examination

                                   creatinine and urea levels are more than normal in serum examination

                                   electrolyte imbalance is seen i.e higher potassium levels  

In edema there will mainly 3 causes i.e due to cardiac failure, liver diseases and renal diseases. And investigations are done to known the functions of the cardiac,liver and kidneys.

urine and blood  examination is done to know whether there is any dysfunction of kidney and urine examination is done for the assessment of filtration function of kidney. We found there is increased levels of albumin is present in urine because of abnormality of filtration membrane.

 on blood examination there is an increased levels of the urea and creatinine in blood i.e kidneys are failing to eliminate the urea and creatinine.

serum and urinary electrolyte examination are done to assess the electrolyte balance function of the kidneys

the decreases levels of RBC count and haemoglobin may be due to the impair of kidney as it is responsible for the release of erythropoietin i.e required for the maturation of the RBC cells.

bacterial culture is done to know the causative agent of infection. 

After observing investigations we can say that edema is due to the decreased levels of albumin i.e decreasing the oncotic pressure in the capillaries and leading to escape of fluid from capillaries to interstital fluid causing edema.

decreased urine out put is due to impairment of the kidneys 

fever is due to candidasis and causing the renal damage

we can conclude that the diagnosis is acute kidney injury secondary to urosepsis with hyperkalemia and anemia.





Question 5

In my opinion this type of clinical exposure is mandatory for every one of the student. This type of learning making us to apply our knowledge that we learnt from text books and classes.

We are learning how to interact with patients and squence of steps required for the proper diagnosis of the disease. It helping us to improve our knowledge day by day.By this gaining some confidence. 

Integration with subject is easy and we can easily memorise the concepts.

 Daily we are able to face many cases and trying to observe and analyse the case, in this process we are learning many new things . 

I want to thank and appreciate all who are trying to help us in this pandemic situation.

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