GENERAL MEDICINE ASSESSMENT

 NAME : M.LAXMI SOWMYA

ROLL NO : 71

3rd Semester

QUESTION 1 

CASE 1 : PULMONOLOGY

A 55 year old female with chief complaints of shortness of breath, pedal edema and facial puffiness

https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html

History of presenting illness ;

 Patient had episodes of shortness of breath for the past 20 years,12 years ago she had another episode of SOB which lasted for 20 days and she had hospitalized and SOB decreased upon treatment at the hospital.

5 years ago she was treated for anemia with iron injection.She was diagnosed with hypertension 20 days ago,pedal edema since 15 days upto the level ankle and pitting type and facial puffiness since 15 days.

PROVISIONAL DIAGNOSIS : ACUTE EXACERBATION OF COPD ASSOCIATED WITH RIGHT HEART FAILURE AND BRONCHIECTASIS 

 IN SEVERE COPD---OXYGEN CONCENTRATION IN THE BLOOD FALLS---PULMONARY HYPERTENSION---HIGH BLOOD PRESSURE IN THE PULMONARY ARTERIES PUTS EXCESS STRAIN ON THE RIGHT VENTRICLE---OVER TIME RIGHT VENTRICLE MAY BECOME STRETCHED AND DILATED AND FAIL TO PUMP BLOOD EFFECTIVELY ---- RIGHT SIDED HEART FAILURE CAUSES FLUID ACCUMULATION IN THE LEGS 

TREATMENT : 

TAB. AZITHROMYCIN 500mg OD 

O2 inhalation to maintain SPO2 above 92%

Inj.AUGUMENT 1.2gm IV BO

TAB PANTOP 40mg PO OD

CASE 2 :  A 52 YEAR OLD MALE WITH CEREBELLAR ATAXIA

https:kausalyavarma.blogspot.com/2021/05/a-52-year-old-male-with-cerebellar.html?m=1

CHIEF COMPLAINTS : Slurring of speech and deviation of mouth

History of presenting illness is that patient had giddiness 7days back and was associated with episode of vomiting on the same day 

Provisional diagnosis: CEREBELLAR ATAXIA secondary to acute cerebrovascular accident with infract in the right inferior cerebellar hemisphere.

Treatment :

tab veratin 8mg PO TID 

Inj zofer 4mg IV/TID 

TAB Ecosprin 75mg PO/OD 

TAB Atorvostatin 40mg po/hs

TAB Clopidogrel 75mg PO/OD 

TAB MVT PO/OD

QUESTION 3 AND 4

CVS CASE

https://60shirisha.blogspot.com/2021/06/medicine-case-discussion_14.html?m=1

This case is about 70 year old female patient presented to casuality with complaints of distension of abdomen and shortness of breath grade 3

History of present illness , history of pass illness, personal and family history was gathered and general examination was done depicting patient is conscious, coherent and no pallor, absence of cyanosis, icterus, clubbing, edema and no lymphadenopathy; systemic examination was also done.

Diagnosis : HFrEF with atrial fibrillation

Investigations : ECG showing atrial fibrillation

                          complete blood picture

                         serum electrolytes

                        glycated hemoglobin

                        C-reactive protein

                        blood sugar random

                        blood urea    

                        serum creatine 

Treatment : Inj.Amiodarone 150 mg IV stat(2doses)

                    Inj.Amiodarone infusion ( 1mg/min till 6hr f/b 0.5 mg/min for next 18 hours)

                    inj.clexane 40mg Sc OD

I very much appreciate the skills and efforts of team of doctors who made these  investigations, diagnosis and finally treated the patient with appropriate medication. There willingness to spend time with the patient for knowing each and every thing about the patient for ruling out misdiagnosis is admirable and shows there compassion, attention for saving the life of a patient.

QUESTION - 5

Due to COVID-19 PANDEMIC we are attending online teaching classes and we are learning new thing every day through this elog in general medicine department. This is very intresting and we are understanding the importance of elog ,case studies of patients virtually and these assesments are very helpful so that we can put this knowledge together into practice in coming days!!!!