General Medicine Assignment

Seemala Anjali

Roll no.123

3rd sem.

I have been given the following cases to solve in an attmept to understand the topic of 'Patient clinical data analysis' to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and diagnosis and coem up with a treatment plan

This is the link regarding assessment:

https://medicinedepartment.blogspot.com/2021/08/medicine-paper-for-aug-2021-bimonthly.html?m=1

Question 1: Peer review

LINK: 

https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006003-case-presentations.html?m=1

Long case : Acute Glomerulopathy

 (Glomerulonephritis / Nephrotic syndrome)

Bilaterally Symmetric Chronic Progressive Inflammatory Peripheral Polyarthritis

A detailed case presentation was done.History is very well taken and presented.History analysis is well done. Diagnostic approach was good.Symptomatology was well explained. It was done precisely.  The work was appreciative. 

Short case-1 :

 1. Idiopathic Parkinson's Disease Stage 1 with denovo HTN.

           2. Multiple System Atrophy - Parkinsonian Type (MSA-P).

History is very well presented .Investigations that are done are clearly mentioned. Presentation was neat.Explanation was good.It was good overall. 

Short case-2 : 

? IATROGENIC CUSHINGS.                SYNDROME . 

                    TINEA CORPORIS .

                     DENOVO HTN .

The information provided was concise and easy to understand. The pictures of the clincal features and investigations are very well placed and that helped us to understand more about the case.  Treatment is also clearly mentioned. It was very well presented. It was good and neat overall. 

QUESTION 2:

Long case:

Problems:

• Facial puffiness.
•  pedal edema (pitting type) extending upto middle of his legs.
• Decreased urine output over past 3 days
• Anasarca
• Frothy urine ( no haematuria)
• Hypoalbuminemia

Provisional diagnosis: Acute Glomerulopathy

 (Glomerulonephritis / Nephrotic syndrome).

Problems:

• Features of inflammation such as severe pain associated with edema of the joints and limitation of range of active movements
• Swellings at joints and deformation of normal joint posture .
• Early morning stiffness lasting for more than 30 mins.
• Features of uncontrolled systemic inflammation like fever , involuntary loss of weight with loss of appetite. 
• Swelling at joints and deformation of normal joint posture. 

Provisional diagnosis: Bilaterally Symmetric Chronic Progressive Inflammatory Peripheral Polyarthritis

Treatment:

• Free water restriction for Hyponatremia
• Tab. PREDNISOLONE P/O 20 mg OD
• Tab FEBUXOSTAT P/O 80 mg OD
• Haemodialysis for worsening renal dysfunction.

Short case-1 

Problems:

• gradually progressive, asymmetric rest tremor with autonomic features .
• stiffness in his wrists (Right>Left), which has now ascended to his elbows.
• movements as involuntary, rhythmic to and fro oscillations.
• sometimes might lose balance
• difficulty in taking stairs up
• reports a loss of sexual desire.

Provisional diagnosis: 1. Idiopathic Parkinson's Disease Stage 1 with denovo HTN.

           2. Multiple System Atrophy - Parkinsonian Type (MSA-P).

Treatment

1. Tab. Syndopa Plus 125 mg QID

2. Tab. Syndopa 125 mg CR OD

3. Tab. Telma 40 mg OD

Short case-2 

• Itchy Ring leisons over arms ,abdomen ,thigh and groin since 1 and half year .
• -Purple stretch marks all over abdomen ,lower back ,upper limbs ,thighs since 1 year .
• Abdominal distension and facial puffiness since 6 months.
•  Pedal edema since 3 months.
• Low back ache since 3 months .
• Feeling low , not feeling to talk to anyone.
• Weight gain and decreased libido since 3months.
• Loss of libido and erectile dysfunction since 2 months .

Provisional diagnosis: IATROGENIC CUSHINGS SYNDROME SECONDARY TO TOPICAL CLOBETASOL APPLICATION ALL OVER BODY FOR APPROXIMATELY ONE YEAR.

TINEA CORPORIS

DENOVO HTN . 

Treatment:

• TAB HIZONE 15 mg per day
• Ointment AMLORFINE 
• FUSIDIC ACID CREAM.
• SALINE COMPRESS OVER LEISONS.
• tab telma 20 mg od .
• Tab Shelcal 500 OD 
•  Tab Vit D 3 Od.
• Tab ULTRACET /PO/SOS.
• Tab Itraconazole 100 mg bd.
•  lulifin cream 
•  tab levocitrixine 5mg od.

QUESTION 3:

QUESTION 4:

https://seemalaanjali123.blogspot.com/2021/08/60-yr-old-female-with-chest-pain.html

QUESTION 5:

Making a e log is very interesting . We are learning how to diagnose a case and what are investigations to be done in a particular case and many more. By reading different e logs we are understanding how the case should be presented. By Peer review , getting the feedback on our blog writing, will improve to do much better.

                    Thank you