osce question

                GENERAL MEDICINE

 BIMONTHLY BENDED ASSESSMENT

NAME:-R SUMANTH RAJ

ROLL NO:-109

QUESTION1:-

REVIEW OF ROLL NO107

1)The necessary questions were posted and checked, reviewed and are assesed appropriately taking into the consideration of patients history, diagnosis and also the treatment part of the diagnosed  disease .

2)The e-log was very informative .

3)adding highlights to text would be helpful to give quick review and glace the concept easily.

4)I found that the reivews are very honest.

question3:-

Again a kind of peer review but this time of the renal failure cases that have been linked in the assignment.  

1)Patients with low back ache and renal failure :

AKI : 

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

This e-log well explained about the daily treatment. 

The points are precised and well written.

The usage of text can be better and it would be good if they add colours for the main headings for highlighting them.

2) Acute on CKD :

👉 http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html

The e-log was very informative and  easy to comprehend the points. 

The usage of highlighted text made the information clear. 

Choice of diagrams, pictures and their placement is good. 

3) CKD :

👉 https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1

The History e-log is presented in a systematic manner. 

General examination and Systemic examination are perfect and thoroughly written. Diagnosis of the patient is well written.

4)Patient with coma and renal failure    

👉 https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html

This is also a case of diabetic with breathlesnes. 

The pt. was diagnosed with Type 2 Diabetes 3 years ago and was put on some oral hypoglycemic agents

5) Patient with coma and renal failure   

👉 https://pallavi191.blogspot.com/2021/06/gm-cases_30.html?m=1

This is bit of complicated case as he was diagnosed with AKI secondary to UTI on CKD. 

 Icterus and pedal edema are seen.

6)Patient with acute on CKD     

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

Post TURP with non oliguria ATN.

 It is a classical case where pus is seen in urine.

 There is a history of  Transurethral Resection of Prostrate.

Hydronephrosis is explained with MRI scans.

7) Patient with acute on CKD  

👉https://rishikakolotimedlog.blogspot.com/2021/07/45-year-old-male-with-chief-complains.html?m=1

He is a known case of DM and hypertension which make him more prone to diseases. 

LFT and RFT are quite abnormal. 

8)Patient with acute on CKD     

👉https://krupalatha54.blogspot.com/2021/06/this-is-online-e-log-book-to-discuss.html?m=1

He was suffering with decreased urine output and vomitings and loose stools which are gradually subsided.

 Even fever is also spiked.

9) Patient with AKI   

👉https://keerthireddy42.blogspot.com/2021/07/43-yr-old-male-of-nalgonda-came-to.html?m=1

 Bilateral pitting edema upto the knew is seen. 

There is dilated veins and distended abdomen . 

Alcoholic hepatitis occured as because of consuming alcohol previously.

10) Patient with AKI   

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

Urosepsis is seen as there is infection of urinary tract.

 Generalized lymphadenopathy is present.

question4:-

CASE-1

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

4)INJ     PANTOP 40mg  IV/OD

5)INJ     THIAMINE  1AMP  IN  100ml   NS   IV/TID

CASE-2

Diagnosis : Hyperuricemia 2° to Renal failure 

Treatment:

• IVF -    NS-0.9%  @100ml/hr

• Inj. Tazar 2.25gm I.V -TID 

• Inj. Lasik 40mg I.V -BD 

CASE-3

Diagnosis:  Chronic interstitial nephritis secondary to plasma cell dyscariasis

Treatment:   

- T. PAN 40mg /PO / OD

- oral fluids upto 1.5 - 2 lit / day

- Protein - x ( plant based ) 2 tablespoon   in 1 glass of  milk  

CASE-4

Diagnosis: DKA with AKI 

Treatment:

Inj. NORAD 2amp in 50ml NS

Inj. PIPTAZ 2.25gm.

Inj. DOPAMINE 2amp in 50ml

Inj. HAI 1ml in 39ml NS

CASE-5

Diagnosis: HFrEF secondary to CAD; CRF

Treatment: 

1. TAB. BISOPROLOL 5mg OD

2.TAB. NITROHART 20/37.5mg 1/2 T/D

3.TAB NICARDIA XL 30mg OD

4.TAB. GLICIAZIDE 80mg BD

5.TAB. NODOSIS 500 mg TD

CASE-6

Diagnosis: INFECTIVE ENDOCARDITIS

Treatment:

1. Inj. Monocef 1gm IV/BD

2. Inj. Vancomycin 500mg IV/BD in 100ml NS over 1hr

3. Proctoclysis enema

4. Inj. Pan 40 mg Iv/OD

CASE-7

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

CASE-8

Diagnosis: Alcoholic Hepatitis and aki sec to gastroenteritis

Treatment: INJ THIAMINE 100 mg in 100 ml NS slow IV / TID 

                    INJ OPTINEURON 1AMP in 100 ml NS slow IV / OD

                    INJ LASIX 40 mg  

CASE-9

Diagnosis: Acute Kidney Injury secondary to Urosepsis

Treatment:

 Inj LASIX 40mg (8am- 2pm -8pm)

IVF - NS @ UO + 50 ml/hr

CASE-10

Diagnosis: pancreatitis in a chronic alcoholic 

Treatment:

IV lasix  40 mg BD .

Tab Nodosis .

IV PIPTAZ 4.5 Gms. BD 

Iv 25%Dextrose. 100 ml BD 

Iv fluids : NS 40 ml /hr.

Question5:-

 It would be easy in learning the basics for clinical practice in offline it is quite difficult in learning all this in online. These case presentations and e-logs are all  difficult to undertake right now for us but, they are also helping us to learn some history taking, diagnosis, causes and  clinical features to a little extent.