Formative assessment
Bimonthly Blended Assessment for August 2021
I, B.Varshitha, roll no.21, student of 3rd semester was given the following formative assessment for bimonthly blended assessment for August, 2021.
This is the link of the questions that are given for this month:
QUESTION-1
LONG CASE:
In this case the 44 year old man presented to the hospital with generalized edema. By taking the history of present illness, came to know about his severe joint pains.Also mentioned about the drugs used for joint pains in the past. History taking was prefect, every minute detail about the present illness is mentioned, by which it became easy for diagnosis of the disease. History analysis was mentioned.
They also mentioned about how they excluded the heart and liver diseases and reasons for mentioning acute glomerulopathy as cause for anasarca and decreased urine output.
It is separately mentioned about inflammatory polyarthritis and its features.
It became easier to analyze the patient condition by taking this kind of history of the patient and mentioned separately the provisional diagnosis.
Every joint is examined carefully by inspection,palpation and checking the range of movements.
It is mentioned clearly about the abnormalities found in the investigation,features supporting the diagnosis
and possible scenarios.
And final provisional diagnosis was acute glomerulopathy,likely due to secondary amyloidosis due to chronic poorly treated seronegative erosive rheumatoid arthritis.
Questions:
1.Abdominal fat pad biopsy vs Renal biopsy ?
My review
In the given answer it is mentioned about the sensitivity of biopsy to diagnose the disease accurately. Also wrote about some history of biopsy.
2. Single DMARD vs Combination therapy?
My review
In the given answer clinical efficacy of methotrexate monotherapy vs combination therapy and data of methotrexate-naïve patients
3. When to initiate dialysis? how long can we wait?
My review
In the answer they mentioned about AKIKI 2 (Artificial Kidney Initiation in Kidney Injury) trial that may help patient to recover.
4. Can Rheumatoid Arthritis and Gout co-exist together?
My review
In the given answer according to the National Health and Nutrition Examination survey prevalence of gout in rheumatoid arthritis was 1.9%
5. Efficacy of Febuxostat vs Allopurinol for Gout?
My review
Mentioned about the method to estimate the efficacy of Febuxostat and allopurinol and results.
Short case 1
A patient presented with a 2month history of progressive asymmetric involuntary movements of his right index and middle fingers.In this case they have mentioned about every detail of present illness in history taking. In addition also mentioned about the educational and immunization history. In nervous system examination, they checked the patient's higher mental functions ,examined cranial nerves and motor system. And diagnosed with idiopathic Parkinson's disease stage 1 with denovo HTN.
Short case 2
In this case 19 year old male came to opd with complaints of itchy ring lesions over arms,abdomen,thigh and groin since 1 and half year ,purple stretch marks all over abdomen,lower back,upper limbs, thighs and also Abdominal distention and facial puffiness.
This case was well presented with proper history taking of the patient. Also mentioned about allergic history. Investigations are done and finally diagnosis is iatrogenic Cushings syndrome secondary to topical clobetasol application all over body for approximately one year.
QUESTION-2
In this case the 44 year old man presented to the hospital with facial puffiness with pedal edema, bilaterally symmetric, pitting type, frothing of urine, gradually decreasing urine output, severe joint pains involving small joints in his hands and wrist, associated with local edema, painful limitation of movements, debilitating early morning pains also reported, he had burning sensation in the eye, developed subcutaneous swellings in the proximal joints of the fingers.
Systemic causes like heart failure and liver dysfunction can be excluded by absence of dyspnea, palpitations and lack of jaundice, melaena or hematemesis.And all the features of inflammatory polyarthritis are present.
And final provisional diagnosis was acute glomerulopathy,likely due to secondary amyloidosis due to chronic poorly treated seronegative erosive rheumatoid arthritis.
QUESTION-3
Review on long case:
In this case the 44 year old man presented to the hospital with generalized edema. By taking the history of present illness, came to know about his severe joint pains.Also mentioned about the drugs used for joint pains in the past. History taking was prefect, every minute detail about the present illness is mentioned, by which it became easy for diagnosis of the disease. History analysis was mentioned.
They also mentioned about how they excluded the heart and liver diseases and reasons for mentioning acute glomerulopathy as cause for anasarca and decreased urine output.
It is separately mentioned about inflammatory polyarthritis and its features.
It became easier to analyze the patient condition by taking this kind of history of the patient and mentioned separately the provisional diagnosis.
Every joint is examined carefully by inspection,palpation and checking the range of movements.
It is mentioned clearly about the abnormalities found in the investigation,features supporting the diagnosis
and possible scenarios.
And final provisional diagnosis was acute glomerulopathy,likely due to secondary amyloidosis due to chronic poorly treated seronegative erosive rheumatoid arthritis.
Review on short case 1
A patient presented with a 2month history of progressive asymmetric involuntary movements of his right index and middle fingers.In this case they have mentioned about every detail of present illness in history taking. In addition also mentioned about the educational and immunization history. In nervous system examination, they checked the patient's higher mental functions ,examined cranial nerves and motor system. And diagnosed with idiopathic Parkinson's disease stage 1 with denovo HTN.
Review on short case 2
In this case 19 year old male came to opd with complaints of itchy ring lesions over arms,abdomen,thigh and groin since 1 and half year ,purple stretch marks all over abdomen,lower back,upper limbs, thighs and also Abdominal distention and facial puffiness.
This case was well presented with proper history taking of the patient. Also mentioned about allergic history. Investigations are done and finally diagnosis is iatrogenic Cushings syndrome secondary to topical clobetasol application all over body for approximately one year.
QUESTION-4
Case report
QUESTION-5
This type of case study is very helpful for us to improve our skills and knowledge . This assignment making us to expose to more and more cases and by analysis and giving the review we are gaining the knowledge about how to assess the provisional diagnosis.
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