GENRAL MEDICINE E-LOG
BIMONTHLY BLENDED ASSESSMENT - JULY 2021
BIMONTHLY BLENDED ASSESSMENT - JULY 2021
—104. JESHMITHA PERUMALLA
Question 1: Competency tested for Peer to peer review and assessment :
Please go through one student's entire answer paper from this link, the one who is closest to your own roll number :
and share your peer review of each answer with your qualitative insights into what was good or bad about the answer.
ANSWER 1:
Link :
https://pavanseshasai103.blogspot.com/
QUALITATIVE INSIGHTS :
All the questions were answered and All the sub-questions have been answered in a detailed and comprehensive manner.
Testing scholarship competency of the examinees was done in an elobrative way.
Diagrams and flowcharts haven't been used if used to make it easier to comprehend. The concepts are explained clearly.
Hence I conclude by Thanking you so much for sharing all this wonderful info with the how-to's!!!! It is so appreciated!!!”
Question 2: Share the link to your own case report of a patient that you connected with and engaged while capturing his her sequential life events before and after the illness and clinical and investigational images along with your discussion of that case.
Answer2: http://jeshmitha104.blogspot.com/2021/07/a-40-year-old-male-patient-e-log_1.html
Question 3: (Testing peer review competency of the examinees) :
Please go through the cases in the links shared above and provide your critical appraisal of the captured data in terms of completeness, correctness and ability to provide useful leads to analyze the diagnostic and therapeutic uncertainties around the cases shared.
LINK1:
https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1
CASE : CKD
The case is presented in a concise systemic manner. Patient history seems adequate as and family history is flagged as insignificant. examinations are provided in a systematic point-wise manner. Investigations done are shared with respective anomalies however, hemoglobin, PCV and leucocyte count isn't mentioned. There has been no investigations about the CKD mentioned in the patient history. Pathological slides are not mentioned multiple myeloma - 70% plasmacytosis is mentioned which gives an idea for probable diagnosis.
Treatment plan shows the drugs administered but does not tell why and what their mechanism of action is.
LINK :2
http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html
CASE : acute on CKD
The case scenario is discussed in a detailed manner but the history was inadequate. The investigations mentioned in the above case like CUE, ABE, S/E & ECG
are not clear.
CNS examination was done in a appreciable manner. This helps in understanding the probable diagnosis.
Treatment used for the patient is mentioned in a correct order. I found this case really interesting .
LINK:3
https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html
CASE: patient with coma & renal failure
The patient had come with complaints of fever and backache with diarrhoea. After which she had a cardiac arrest for which CPR was administered.lab findings like complete blood picture,LFTs and RFTs where ordered which showed increased levels of urea and creatinine for which she was put on dialysis.Later USG was done which revealed and enlarged kidney and gradually her haemoglobin levels had come down due to lack of stimulation by erythropoietin for synthesis of RBC. Due to her persistent vegetative state and no improvement in her coma scale an MRI was ordered which confirmed that there's Septic shock due to hypoxemia. Also the bed sores were due to a hospital acquired infection which cannot be healed by the patient herself because she's a known diabetic,hence the degeneration and necrosis of tissue at the site. Hence, timely care and repeated change of dressing was done to relieve her of the pain. But there is poor prognosis and hence she was discharged.
LINK : 4
https://keerthireddy42.blogspot.com/2021/07/43-yr-old-male-of-nalgonda-came-to.html?m=1
CASE : AKI
Case scenario of this patient is a bit confused. History taking is adequate, Investigations done are shared with respective anomalies however the gastroduodenitis endoscopy is not clear. All the examinations were done in a correct order.
The patient with bilateral pedal edema and liver span 9cm with alcohol dependence syndrome and grade 2 fatty liver gives a path for secondary diagnosis
Treatment was absolutely clear, after 5 days of the treatment given to the patient his investigations are still abnormal.
And a query unsolved for me is that an on going case! .The date of discharge is not mentioned in the blog.
Question 4: Testing scholarship competency of the examinees ( ability to read comprehend, analyze, reflect upon and discuss captured patient centered data as in their 'original' answers to the assignment for May 2021):
Please analyze the above linked patient data by first preparing a problem list for each patient (based on the shared data) and then discuss the diagnostic and therapeutic uncertainty around solving those problems. Also include the review of literature around sensitivity and specificity of the diagnostic interventions mentioned and same around efficacy of the therapeutic interventions mentioned for each patient.
Answer 4:
LINK 1: https://krupalatha54.blogspot.com/2021/07/a-49-yr-old-female-with-generalized.html?m=1
Diagnostic and therapeutic uncertainty-
No diagnostic and therapeutic uncertainty
LINK 2:
http://srinaini25.blogspot.com/2021/07/srinaini-roll-no-33-3rd-semester-this.html
Diagnostic and therapeutic uncertainty:
The clinical diagnosis is not mentioned.No therapeutic uncertainties
LINK 3:
https://ananyapulikandala106.blogspot.com/2021/06/a-35yr-old-female-elog.html
Diagnostic and therapeutic uncertainty :
No diagnostic & therapeutic uncertainties
LINK 4:
https://keerthireddy42.blogspot.com/2021/07/43-yr-old-male-of-nalgonda-came-to.html?m=1
Diagnostic and therapeutic uncertainty
No Diagnostic uncertainties
Not sure about therapeutic uncertainties, because even after certain treatment the patient had many investigational abnormalities.
Question 5: Please reflect on and share your telemedical learning experiences from the hospital as well as community patients over the last month particularly while you were E logging their case report while even in the hospital or perhaps when locked down at home.
Answer 5: Although the pandemic has taken from me the experience of clinical postings, online interactions with the faculty have helped. throughout this process I have learned how to access the internet and research scholarly articles based on the case presented to me and understand the care given. The WhatsApp group although disorganized has exposed me to clinical information that I would never have gotten during lockdown. Overall I appreciate the efforts of the faculty in making General Medicine interactive and fun to learn. I'm also glad that we are connected to our patients discussing about their illnesses through telepathy,we're learning and exploring new medical cases through this new change that's bought up in our lives :)
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