67 K. Sai Likhitha

BIMONTHLY  BLENDED ASSESSMENT - JUNE 2021

Name- K. Sai Likhitha

Roll no- 67

Batch - 2019 3rd semester

Link to the assessment/ question paper- https://medicinedepartment.blogspot.com/2021/06/medicine-department-paper-for-june-2021.html?m=1

Question 1 - Competency tested for Peer to peer review and assessment.

1. Roll no 67

Neurology case

Case- https://67ankithareddy.blogspot.com/2021/05/medicine-blended-assignment-may-2021.html?m=1

Quantitative marking- 9/10

Qualitative assessment- The case was about a 40 yr old male with complaints of irrelevant talking. He is a chronic alcoholic and the neurological manifestations in this patient are primarily due to thiamine deficiency and increase in levels of toxins in the body due to renal disease.

The elog was well presented and the answers to the questions were given to the point with appropriate pictures.

2. Roll no 26

Pulmonology case

Case- http://santhoshdarimedi.blogspot.com/2021/05/medicine-blended-assignment.html

Quantitative marking- 8/10

Qualitative assessment- The case was about a 55 year old female patient, with the chief complaints of shortness of breath, pedal edema and facial puffiness. 

The information was provided point wise and neatly presented. Diagram / flowchart would have been helpful. Overall it was good and easy to comprehend. 

3. Roll no 93

Cardiology case

Case- https://93deepanandikonda.blogspot.com/2021/05/blended-bimonthly-assignment-toward.html

Quantitative marking-9/10

Qualitative assessment- The case was about a 78 years old male with complaints of sob, chest pain, bilateral pedal edema and facial puffiness.

The elog was presented very well. It ws very neat and clear with appropriate pictures. Highlighting the important points is appreciated. Different topics are clearly marked and separated. Mechanisms are explained very well.

4. Roll no 1

Nephrology and urology case

Case- https://aitharaveena.blogspot.com/2021/05/online-blended-medicine-assignment-may.html

Quantitative marking- 9/10

Qualitative assessment- The case was about a 52 year old male patient with shortness of breath burning micturition and fever.

It was presented very neatly and clearly. Necessary and important points were highlighted. Everything was very well presented.

5. Roll no 95 

Gastroenterology case

Case- https://raveelaravi.blogspot.com/2021/06/medicine-case-discussion.html

Quantitative marking-7/10

Qualitative assessment- The case was about a 25 year old male with epigastric pain.

Some answers to the questions were very brief while some were appropriate and to the point. The sites and links are not mentioned at some places. It would have been good if mechanisms and etc are explained with pictures and flowcharts.

6. Roll no 100

Infectious diseases and hepatology case

Case- https://nehae-logs.blogspot.com/2021/05/bimonthly-assignment-for-may-2021.html

Quantitative marking-9/10

Qualitative assessment- The case was about a liver abscess in a chronic alcoholic patient.

The answers to the questions were given very well with appropriate pictures, flowcharts and also reference links. The flowcharts are appreciated. Overall it was very clear and neatly presented.

7. Roll no 108

Infectious diseases

Case- http://108subramanyamelogcases.blogspot.com/2021/05/online-blended-bimonthly-assignment.html

Quantitative marking- 7/10

Qualitative assessment- The answers were very brief. Adding pictures and flowcharts to the elog would have made it better. Little bit more detailing of the topic would have elevated the presentation. It was easy to comprehend.

8. Roll no 117

Cardiology case

Case- https://lasyasakilam27.blogspot.com/2021/05/medicine-bimonthly-assessment.html

Quantitative marking- 8/10

Qualitative assessment- The case was about a patient with acute myocardial infarction.

The information provided was concise and to the point. The pharmacological interventions and placebo thing was presented well in tabular form. It was easily comprehensible and little detailing is necessary for some topics.

9. Roll no 70

Neurology case

Case- https://70pranaykp.blogspot.com/2021/05/general-medicine-assignment-may-2021.html

Quantitative marking-8/10

Qualitative assessment- Mechanisms were eloborated well.  Point wise manner of answering and highlighting important points would have made it easier to read and understand. Overall it was well.

10. Roll no 4

Neurology case

Case- https://amitsharma1996.blogspot.com/2021/05/medicine-assignment-may-2021.html

Quantitative marking-6/10

Qualitative assessment- Answers were very brief.  Tabulation of some topics would have made it easier to understand. Pictures, diagrams, flowcharts would have been helpful. Highlighting has not being done.

Question 2- 

I haven't got a chance to make a case report yet.

Question 3- Testing peer review competency of the examinees.

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

The case was of a 28 year old male with chief complaints of sudden fall followed by weakness of both the lower limbs (paraplegia) and loss of hand grip 10 days back, associated with bowel and bladder incontinence. The final diagnosis of the patient is Quadreparesis secondary to infectious spondylitis of C4, C5, C6, C7 and D1 with Epidural abscess at C5 - C6 level.

My critical appraisal of the case.

• The data of the patient is captured very well.
• The pictures of the patient were captured properly without revealing the patient identity.

• The history of the patient is covered clearly including history of present illness, past history, family history and the personal history.  
• The general examination and systematic examination of the patient were performed well and presented clearly with appropriate grading of the reflexes.

• All the investigations done are attached in the elog.

• The diagnostic and therapeutic uncertainties around the case were analysed correctly. Intially the provisional diagnosis was cervical myelopathy and pott's spine but later finally it was diagnosed as quadriceps secondary to infectious spondylitis.

• Overall the data in the case is well covered and completed including the diagnostic and therapeutic uncertainties involved with the case.

Question 4- Testing scholarship competency of the examinees.

Case 1- Multisystem

Link- https://nikithaedam48.blogspot.com/2021/06/18-year-old-malefrom-miryalagudawho-is.html?m=1

List of problems:

• Low backache one week ago.
• Fever since 5 days.
• yellowish discolouration of eyes since 3 days. 
• Vomitings.
•  loose stools and blood tinged urine.
• Lose of weight since 6 months.
• Polyuria, nocturia and polydipsia since 2 months.

Diagnostic and therapeutic uncertainties around the case:

The provisional diagnosis was acute viral hepatitis, denovo DM 1, diabetic ketoacidosis as the patient's lft was abnormal. The final diagnosis was acute fulminant hepatic failure secondary to bacterial/ viral infection (as toxins were found) with hepatic encephalopathy, coagulopathy due to disturbance in the hemostasis which occurs due to liver failure. Diabetic ketoacidosis was resolved.

Case 2- CNS

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

List of problems:

• weakness of both the lower limbs (paraplegia). 
• Loss of hand grip 10 days back.
•  bowel and bladder incontinence.
• generalized weakness and myalgia 15 days back.
• AFB bacilli.
• TB

Diagnostic and therapeutic uncertainties around the case:y

The provisional diagnosis was cervical myelopathy and pott's spine. The final diagnosis was Quadreparesis secondary to infectious spondylitis of C4, C5, C6, C7 and D1 with Epidural abscess at C5 - C6 level. Cervical myelopathy is a degenerative condition caused by compression of spinal cord. Pott's spine is a kind of tubercular arthritis of intervertebral joints. MRI brain with cervical spine has showed infectious spondylitis of C4, C5, C6, C7 and epidural abscess at C5-C7.

Case 3 - Renal

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

List of problems:

• Hypertension.
• Chronic kidney disease.
• Altered Sensorium (Hypo active), lethargy.
• Fever 10 days back.
• Pedal edema with Anasarca.
• Shortness of breath even at rest.

Diagnostic and therapeutic uncertainties around the case:

The patient is a known case of chronic kidney disease. The diagnosis of the patient was acute kidney injury on chronic kidney disease (hypertensive disease nephropathy) with uremic encephalopathy. The clinical manifestations in the patient were due to increased fluid content in the body due to kidney failure. Uremic encephalopathy is due to accumulation of toxins in the brain due to acute or chronic renal failure.

Case 4- CVS

Link- https://60shirisha.blogspot.com/2021/06/medicine-case-discussion_14.html?m=1

List of problems:

• Distension of abdomen.
• Shortness of breath.
• Hypothyroidism.

Diagnostic and therapeutic uncertainties around the case:

ECG showed atrial fibrillation. 2d echo showed pleural effusion and mild pericardial effusion. The diagnosis of the case was heart failure with reduced ejection fraction (HFrEF) with atrial fibrillation. HFrEF occurs when left side of the heart does not pump blood out to the body.

Case 5 - Abdominal 

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

List of problems:

• Pedal edema.
• Decreased urine output.
• Fever.
• Type 2 diabetes mellitus.
• Shortness of breath.
• Acute kidney failure.

Diagnostic and therapeutic uncertainties around the case:

The diagnosis of the case was acute kidney injury secondary to urosepsis (infection of urinary tract) with anemia of chronic disease. Hyperkalemia was resolved. The clinical symptoms are due to increased fluid content in the body due to acute kidney injury.

Question 5- Testing scholarship competency in  logging reflective observations:

The telemedical learning from the hospital has been a new experience and we are learning a quite lot of things through reflective observation. Although we cannot make a critical comment as we are never exposed to face to face interaction with patients at hospital and don't know how that'll be but as of now it's a bit challenging as we have just entered our 2nd MBBS. This virtual case discussion is a concrete experience as we are being involved in new things. We have learnt elogging of the cases in a very short span of time with the help of interns and professors. By doing this assignment I could view my seniors elogs and learned a few things from their presentations.