General medicine bimonthly assessment August-

General medicine assessment

Name:Alekya kallem
Batch:2019


Long question:
Q1
𝑪𝒂𝒔𝒆 1𝒍𝒊𝒏𝒌-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006001-case-presentations.html 

𝑪𝒂𝒔𝒆 𝒊𝒏 𝒃𝒓𝒊𝒆𝒇-A 47 year male patient resident of Nalgonda came with chief complaints of abdominal distension and swelling of bilateral lower limbs since 6 months which is gradually increasing since 10 days and fluid discharge from the umbilical area since 2 days and fever since 2 days. 

𝑰𝒏𝒔𝒊𝒈𝒉𝒕𝒔-
The scenario of the case was clearly presented. And also all the investigation reports were updated regularly. It would have been even better if the treatment is updated regularly.



𝑺𝒉𝒐𝒓𝒕 𝒄𝒂𝒔𝒆𝒔:
Q2.
𝑪𝒂𝒔𝒆 1 𝒍𝒊𝒏𝒌-https://2018-21batchpgy3gmpracticals.blogspot.com/2021/08/18100006001-case-presentations.html 

𝑪𝒉𝒆𝒊𝒇 𝒄𝒐𝒎𝒑𝒍𝒂𝒊𝒏𝒕𝒔-
• Vomitings
• Abdominal pain since 4days
• Swelling of right foot non pitting type
• Anorexia,myalgia,fatigue and anasarca since 5days 

𝑫𝒊𝒂𝒈𝒏𝒐𝒔𝒊𝒔
Acute kidney injury , secondary to acute tubular necrosis , due to snake bite . 


𝑻𝒓𝒆𝒂𝒕𝒎𝒆𝒏𝒕 𝒑𝒍𝒂𝒏 

1. 4 sessions of haemodialysis
2. Inj zofer 4 mg TID
3. Inj pan 40 mg Od
4. Strict input / output    charting.



Q3

𝑪𝒉𝒊𝒆𝒇 𝒄𝒐𝒎𝒑𝒍𝒂𝒊𝒏𝒕𝒔-
• Fever since 3 months 
• Cough with expectoration since 2 months 
• Dyspnea on exertion since 2 months 
• Vomiting since 2 months
• Decreased appetite 
• weight loss over last 2 months 
• Dark coloured stools since 2 weeks.  

𝐃𝐢𝐚𝐠𝐧𝐨𝐬𝐢𝐬
Heart failure with reduced ejection fraction-27%
Type 2 diabetes mellitus 

𝐓𝐫𝐞𝐚𝐭𝐦𝐞𝐧𝐭 𝐩𝐥𝐚𝐧
• Tab Lasix 80mg in the morning, 40mg in the afternoon and evening 
•  Tab Isosorbide mononitrate 10mg twice a day 
• Tab Hydralazine 25mg  
• Tab Telma 40mg 
• Tab Metformin 500mg once a day  

He was advised to take  fluids  less than 1 litre and salt restriction of less than 2grams/day to avoid retention of fluid in the abdomen.

Q4.  
We are not yet assigned to any intern yet as we didnt get our roll numbers. 





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