GENERAL MEDICINE ASSESSMENT

 I am,Pakker vaishnavi ,MBBS 3rd semester holding roll no 99 

QUESTION:1

                     

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

A 55 yr old female patient 

CHIEF COMPLAINTS 

•shortness of breath  

• pedal edema

• Facial puffiness 

HISTORY:

•diabetes mellitus since 8yrs

•anemia and took iron injections 5 yrs ago 

• generalized weakness since 1 month

•hypertension 

• pedal edema, facial puffiness since 15 days 

INVESTIGATIONS:

•2d echo

•ecg

• abg levels

• serum iron

• serum electrolytes 

• lft

• rft

• chest x ray

• hrct

DIAGNOSIS:

Acute exacerbation of COPD associated with right heart failure and bronchiectasis.

                              COPD

Chronic obstructive pulmonary disease, commonly referred to as COPD, is a group of progressive lung diseases.

                           BRONCHIECTASIS 

condition in which the lungs' airways become damaged, making it hard to clear mucus.

Bronchiectasis may result from an infection or medical condition, such as pneumonia or cystic fibrosis. Mucus builds up and breeds bacteria, causing frequent infections.

QUESTION: 3,4 

https://61tejarshini.blogspot.com/2021/06/general-medicine-case-discussion.html?m=1

45 yrs old male patient 

CHIEF COMPLAINTS:

• alterd sensorium 

• fever 

• pedal edema 

• shortness of breath 

HISTORY:

•hypertension 

•chronic kidney disease 

•no history of diabetes mellitus, TB,CAD, asthma

INVESTIGATIONS:

• ECG 

• complete urine analysis 

• ultra sound 

• anti hcv antibodies 

DIAGNOSIS :

•AKI ON CKD(HYPERTENSIVE NEPHROPATHY) WITH URAEMIC ENCEPHALOPATHY.

PLANNING FOR HEMODIALYSIS

TREATMENT:

IVF-NS(0.0+30ml/hr)

INJ.LASIX(40mg/IV/TID)

INJ.NaHCO3(100meq in 100ml NS/IV/Stat)

T.NODOSIS 550mg/P.O/TID

BP/PR/Strict I/O Charting

QUESTION 5:

Clinical postings are very interesting. As they are conducting online there is a little difficulty in understanding but as days are going on we r understanding them better and we are thankful for general medicine department for giving us this information