August medicine department bimonthly assessment

MEDICINE  DEPARTMENT BIMONTHLY ASSESSMENT

                                          JUNE 2021

Max marks:100[5 x 20marks]
Submit by : 31/6/2021

QUESTION 1: Competency tested for peer to peer assessment

. Hconsidered for review:
Batch :2017 MBBS batch 
Roll Numbers:

Question considered for review: CASE 2:NEUROLOGY

MY QUANTITATIVE AND QUALITATIVE INPUTS ON PEER ANSWERRS

A]LINK TO PATIENT DETAILS:

QUESTION 1:What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patient's problem?






REVIEW OF ROLL NO 80 :Presented in a clear way with proper differentiation of question
REVIEW OF ROLL NO 81:Correct information but failed to present in a proper chronological order
REVIEW OF ROLL NO 82 :Very good presentation also included the symptomatology after admission gave a detailed anatomical localization and proper etiology
REVIEW OF ROLL NO 85: Improper order of symptoms and etiology
REVIEW OF ROLL NO 86: Too much of information not related to the given question however neat presentation and images
REVIEW OF ROLL NO 87: There is no proper differentiation of answer and is hard to find relevant points
REVIEW OF ROLL NO 89:There is slight question in the answer it is not clear
REVIEW OF ROLL NO 91:There is no mention of anatomical localization
REVIEW OF ROLL NO 92:The anatomical localization is not clear
REVIEW OF ROLL NO 93 :Very neat presentation but improper timeline:

QUESTION 2: What are mechanism of action, indication and efficacy over placebo of each of the pharmacological and non pharmacological interventions used for this patient?

REVIEW OF ROLL NO 80: Proper reason of why placebo are ineffective is given
REVIEW OF ROLL NO 81: Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 82:Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 85: Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 86: Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 87: Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 89: Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 91: Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 92 :Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 93 : Proper reason of why placebo are ineffective is given

QUESTION 3:Why have neurological symptoms appeared this time, that were absent during withdrawal earlier? What could be a possible cause for this?



REVIEW OF ROLL NO 80:Cause properly explained
REVIEW OF ROLL NO 81:Cause not properly explained
REVIEW OF ROLL NO 82 :Cause properly explained with diagrams
REVIEW OF ROLL NO 85 :Cause not properly explained
REVIEW OF ROLL NO 86:Cause not properly explained
REVIEW OF ROLL NO 87:Cause not properly explained
REVIEW OF ROLL NO 89:Cause properly explained
REVIEW OF ROLL NO 91:Cause not properly explained
REVIEW OF ROLL NO 92:Cause not properly explained
REVIEW OF ROLL NO 93:Cause properly explained with diagrams

QUESTION 4:What is the reason for giving thiamine in this patient?

REVIEW OF ROLL NO 80 : Reason is properly given
REVIEW OF ROLL NO 81 : Reason is properly given
REVIEW OF ROLL NO 82 : Reason is properly given with diagrams
REVIEW OF ROLL NO 85  :Reason is properly given
REVIEW OF ROLL NO 86  :Reason is properly given
REVIEW OF ROLL NO 87  :Reason is properly given
REVIEW OF ROLL NO 89  :Reason is properly given with diagrams
REVIEW OF ROLL NO 91  :Reason is properly given
REVIEW OF ROLL NO 92  :Reason is properly given
REVIEW OF ROLL NO 93 : Reason is properly given with diagrams

QUESTION 5: What is the probable reason for kidney injury in this patient? 




REVIEW OF ROLL NO 80  :Reason is properly given with diagrams
REVIEW OF ROLL NO 81  :Reason is properly given
REVIEW OF ROLL NO 82  :Reason is properly given
REVIEW OF ROLL NO 85  :Reason is properly given
REVIEW OF ROLL NO 86  :Reason is properly given with diagrams
REVIEW OF ROLL NO 87  :Reason is properly given with a flow chart
REVIEW OF ROLL NO 89  :Reason is not properly given
REVIEW OF ROLL NO 91  :Reason is properly given
REVIEW OF ROLL NO 92  :Reason is properly given with diagrams
REVIEW OF ROLL NO 93   :Reason is properly given with diagrams

QUESTION 6: What is the probable cause for the normocytic anemia?

REVIEW OF ROLL NO 80  :Reason is properly given
REVIEW OF ROLL NO 81  :Reason is not given properly 
REVIEW OF ROLL NO 82  :Reason is properly given 
REVIEW OF ROLL NO 85  :Reason is properly given 
REVIEW OF ROLL NO 86  :Reason is properly given with diagrams
REVIEW OF ROLL NO 87  :Reason is properly given 
REVIEW OF ROLL NO 89  :Reason is properly given 
REVIEW OF ROLL NO 91  :Reason is properly given
REVIEW OF ROLL NO 92  :Reason is properly given with diagrams
REVIEW OF ROLL NO 93   :Reason is properly given 

QUESTION 7: Could chronic alcoholism have aggravated the foot ulcer formation? If yes, how and why?

REVIEW OF ROLL NO 80  :Reason is properly given
REVIEW OF ROLL NO 81  :Reason is improperly given 
REVIEW OF ROLL NO 82  :Reason is properly given 
REVIEW OF ROLL NO 85  :Reason is properly given 
REVIEW OF ROLL NO 86  :Reason is properly given 
REVIEW OF ROLL NO 87  :Reason is properly given 
REVIEW OF ROLL NO 89  :Reason is not properly given 
REVIEW OF ROLL NO 91  :Reason is properly given 
REVIEW OF ROLL NO 92  :Reason is properly given 
REVIEW OF ROLL NO 93   :Reason is properly given with a graph

B] LINK TO PATIENT DETAILS:


QUESTION 1 :What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patient's problem?




REVIEW OF ROLL NO 80: Proper symptomatology and localization and etiology are given
REVIEW OF ROLL NO 81 :Not attempted
REVIEW OF ROLL NO 82: Time line even before the onset of symptoms is given and the localization and etiology is neatly presented
REVIEW OF ROLL NO 85:Proper symptomatology and localization and etiology are given but not presented properly
REVIEW OF ROLL NO 86:Time line is neatly drawn and proper localization and etiology are given
REVIEW OF ROLL NO 87:Proper symptomatology and localization and etiology are given
REVIEW OF ROLL NO 89 :Proper symptomatology and etiology are given but proper localization is not given
REVIEW OF ROLL NO 91 :Proper symptomatology and localization and etiology are given
REVIEW OF ROLL NO 92 :Proper symptomatology and localization and etiology are given
REVIEW OF ROLL NO 93 :Proper symptomatology and localization and etiology are given

QUESTION 2 :What are mechanism of action, indication and efficacy over placebo of each of the pharmacological and non pharmacological interventions used for this patient?

REVIEW OF ROLL NO 80: Proper reason of why placebo are ineffective is given
REVIEW OF ROLL NO 81: Not attempted
REVIEW OF ROLL NO 82: Proper mechanism of action is given and proper reason of why placebo are ineffective is given
REVIEW OF ROLL NO 85: Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 86: Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 87: Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 89: Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 91: Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 92 :Proper mechanism of action is given but no reason of placebo is mentioned
REVIEW OF ROLL NO 93 : Proper reason of why placebo are ineffective is given and explained with many diagrams and flow charts


QUESTION 3 : Did the patients history of de novo HTN contribute to his current condition?

REVIEW OF ROLL NO 80 : Reason correctly answered and properly explained
REVIEW OF ROLL NO 81Not attempted
REVIEW OF ROLL NO 82 :Reason correctly answered and properly explained with diagram
REVIEW OF ROLL NO 85 : Reason correctly answered and properly explained
REVIEW OF ROLL NO 86 :Reason correctly answered and properly explained with reference
REVIEW OF ROLL NO 87 : Reason correctly answered and properly explained
REVIEW OF ROLL NO 89 : Not attempted
REVIEW OF ROLL NO 91 : Reason correctly answered and properly explained
REVIEW OF ROLL NO 92 : Reason correctly answered and properly explained
REVIEW OF ROLL NO 93  : Reason correctly answered and properly explained

QUESTION 4: Does the patients history of alcoholism make him more susceptible to ischemic or Haemorrhagic type of stroke?

REVIEW OF ROLL NO 80 Reason correctly answered and properly explained
REVIEW OF ROLL NO 81 :Not attempted
REVIEW OF ROLL NO 82 Reason correctly answered and properly explained
REVIEW OF ROLL NO 85 Reason correctly answered and properly explained
REVIEW OF ROLL NO 86 :Reason correctly answered and properly explained with reference
REVIEW OF ROLL NO 87 :Reason correctly answered and properly explained with diagram
REVIEW OF ROLL NO 89 Reason correctly answered but not properly explained
REVIEW OF ROLL NO 91 Reason correctly answered and improperly explained
REVIEW OF ROLL NO 92 Reason correctly answered and improperly explained
REVIEW OF ROLL NO 93  Reason correctly answered and properly explained

C] LINK TO PATIENT DETAILS:


QUESTION 1 :What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patient's problem?

REVIEW OF ROLL NO 80: Proper symptomatology and localization and etiology are given
REVIEW OF ROLL NO 81 :Not attempted
REVIEW OF ROLL NO 82: Time line even before the onset of symptoms is given and the localization and etiology is neatly presented
REVIEW OF ROLL NO 85:Proper localization and etiology are given but time line is not given
REVIEW OF ROLL NO 86:Time line is neatly drawn and proper localization and etiology are given
REVIEW OF ROLL NO 87:Proper symptomatology and localization and etiology are given
REVIEW OF ROLL NO 89 :Proper symptomatology and etiology are given but proper localization is not given
REVIEW OF ROLL NO 91 :Proper symptomatology and localization and etiology are given
REVIEW OF ROLL NO 92 :Proper symptomatology and localization and etiology are given
REVIEW OF ROLL NO 93 :Proper symptomatology and localization and etiology are given through pictures

QUESTION 2: What are the reasons for recurrence of hypokalemia in her? Important risk factors for her hypokalemia?

REVIEW OF ROLL NO 80Reason correctly answered and properly explained
REVIEW OF ROLL NO 81Not attempted
REVIEW OF ROLL NO 82Reason correctly answered but not properly explained
REVIEW OF ROLL NO 85Reason correctly answered but not properly explained
REVIEW OF ROLL NO 86Reason correctly answered and properly explained
REVIEW OF ROLL NO 87Reason correctly answered and properly explained with table
REVIEW OF ROLL NO 89 not attempted
REVIEW OF ROLL NO 91Reason correctly answered and properly explained
REVIEW OF ROLL NO 92Reason correctly answered and properly explained
REVIEW OF ROLL NO 93 Reason correctly answered and properly explained

 QUESTION 3 :What are the changes seen in ECG in case of hypokalemia and associated symptoms?

REVIEW OF ROLL NO 80 :Reason correctly answered and properly explained with diagram  
REVIEW OF ROLL NO 81 :Not attempted
REVIEW OF ROLL NO 82 : Reason correctly answered and properly explained
REVIEW OF ROLL NO 85  :Reason correctly answered and properly explained
REVIEW OF ROLL NO 86  :Reason correctly answered and properly explained with diagram
REVIEW OF ROLL NO 87 : Reason correctly answered and properly explained
REVIEW OF ROLL NO 89 : Reason correctly answered and properly explained
REVIEW OF ROLL NO 91 : Reason correctly answered and properly explained
REVIEW OF ROLL NO 92 :Reason correctly answered and properly explained with diagram
REVIEW OF ROLL NO 93 : Reason correctly answered and properly explained with diagram and graph 

D] LINK TO PATIENT DETAILS:

QUESTION 1 : Is there any relationship between occurrence of seizure to brain stroke. If yes what is the mechanism behind it?

REVIEW OF ROLL NO 80 :Reason correctly answered and properly explained with diagram and flow chart
REVIEW OF ROLL NO 81Not attempted
REVIEW OF ROLL NO 82 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 85 :Reason correctly answered and properly explained
REVIEW OF ROLL NO 86 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 87 :Reason correctly answered and properly explained with diagram
REVIEW OF ROLL NO 89 :Reason correctly answered and properly explained
REVIEW OF ROLL NO 91 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 92 :Reason correctly answered and properly explained with diagram and flow chart
REVIEW OF ROLL NO 93 :Reason correctly answered and properly explained with flow charts


QUESTION 2 :In the previous episodes of seizures, patient didn't loose his consciousness but in the recent episode he lost his consciousness what might be the reason?

REVIEW OF ROLL NO 80 : Reason is properly given
REVIEW OF ROLL NO 81Not attempted
REVIEW OF ROLL NO 82 : Reason is properly given with diagram
REVIEW OF ROLL NO 85 : Reason is improperly given
REVIEW OF ROLL NO 86 : Reason is properly given
REVIEW OF ROLL NO 87 : Reason is properly given
REVIEW OF ROLL NO 89 : Reason is properly given
REVIEW OF ROLL NO 91 : Reason is properly given
REVIEW OF ROLL NO 92 : Reason is properly given
REVIEW OF ROLL NO 93  : Reason is properly given

E] LINK TO PATIENT DETAILS:


QUESTION 1 :What could have been the reason for this patient to develop ataxia in the past 1 year?


REVIEW OF ROLL NO 80 : Reason is correctly explained
REVIEW OF ROLL NO 81Not attempted
REVIEW OF ROLL NO 82 : Reason is correctly explained with diagram
REVIEW OF ROLL NO 85 : Reason is partially explained
REVIEW OF ROLL NO 86 : Reason is correctly explained
REVIEW OF ROLL NO 87 : Reason is partially explained
REVIEW OF ROLL NO 89 : Reason is partially explained
REVIEW OF ROLL NO 91 : Reason is partially explained
REVIEW OF ROLL NO 92 : Reason is correctly explained
REVIEW OF ROLL NO 93  : Reason is correctly explained

QUESTION 2 : What was the reason for his IC bleed? Does Alcoholism contribute to bleeding diatheses ?

REVIEW OF ROLL NO 80 Reason is correctly given and neatly presented
REVIEW OF ROLL NO 81Not attempted
REVIEW OF ROLL NO 82 Reason is correctly given and neatly presented
REVIEW OF ROLL NO 85 Reason is correctly given 
REVIEW OF ROLL NO 86 Reason is correctly given 
REVIEW OF ROLL NO 87 Reason is correctly given and neatly presented 
REVIEW OF ROLL NO 89 Reason is correctly given 
REVIEW OF ROLL NO 91 Reason is correctly given 
REVIEW OF ROLL NO 92 Reason is correctly given and neatly presented
REVIEW OF ROLL NO 93  Reason is correctly given and neatly presented 


F] LINK TO PATIENT DETAILS:




QUESTION 1 :Does the patient's  history of road traffic accident have any role in his present condition?

REVIEW OF ROLL NO 80 :Reason incorrectly answered 
REVIEW OF ROLL NO 81Not attempted
REVIEW OF ROLL NO 82 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 85 :Reason incorrectly answered 
REVIEW OF ROLL NO 86 :Reason incorrectly answered 
REVIEW OF ROLL NO 87 :Reason in correctly answered 
REVIEW OF ROLL NO 89 :Reason incorrectly answered
REVIEW OF ROLL NO 91 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 92 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 93 :Reason correctly answered and properly explained  


QUESTION 2 :What are warning signs of CVA?




REVIEW OF ROLL NO 80 :Proper explanation of signs with diagram
REVIEW OF ROLL NO 81 :Not attempted
REVIEW OF ROLL NO 82 :Proper explanation of signs 
REVIEW OF ROLL NO 85 :Proper explanation of signs 
REVIEW OF ROLL NO 86 :Proper explanation of signs with diagram
REVIEW OF ROLL NO 87 :Proper explanation of signs 
REVIEW OF ROLL NO 89 :Proper explanation of signs 
REVIEW OF ROLL NO 91 :Proper explanation of signs 
REVIEW OF ROLL NO 92 :Proper explanation of signs 
REVIEW OF ROLL NO 93 :Proper explanation of signs with diagram 

QUESTION 3 :What is the drug rationale in CVA?

REVIEW OF ROLL NO 80 :Drug rationale correctly explained
REVIEW OF ROLL NO 81 :Not attempted
REVIEW OF ROLL NO 82 :Drug rationale correctly explained 
REVIEW OF ROLL NO 85 :Drug rationale correctly explained
REVIEW OF ROLL NO 86 :Drug rationale correctly explained
REVIEW OF ROLL NO 87 :Drug rationale correctly explained
REVIEW OF ROLL NO 89 : Drug rationale correctly explained
REVIEW OF ROLL NO 91 : Drug rationale correctly explained
REVIEW OF ROLL NO 92 : Drug rationale correctly explained with diagrams
REVIEW OF ROLL NO 93 : Drug rationale correctly explained with diagrams

QUESTION 4 :Does alcohol has any role in his attack?

REVIEW OF ROLL NO 80 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 81  :Not attempted
REVIEW OF ROLL NO 82 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 85 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 86 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 87 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 89 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 91 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 92 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 93  :Reason correctly answered and properly explained 

QUESTION 5 :Does his lipid profile has any role for his attack??

REVIEW OF ROLL NO 80 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 81Not attempted
REVIEW OF ROLL NO 82 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 85 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 86 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 87 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 89 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 91 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 92 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 93  :Reason correctly answered and properly explained 
 
G] LINK TO PATIENT DETAILS:


QUESTION 1 :What is myelopathy hand ?

Myelopathy hand is characterized by muscle wasting and motor dysfunction        related with cervical spondylosis. 
This is termed as " Amyotrophic type of myelopathy  hand ". 
The main clinical features are localized wasting and weakness of extrinsic and intrinsic muscles of hand but is not accompanied by either sensory loss 





REVIEW OF ROLL NO 80 :Properly explained with picture
REVIEW OF ROLL NO 81 :Not attempted
REVIEW OF ROLL NO 82 :Properly explained 
REVIEW OF ROLL NO 85 :Properly explained 
REVIEW OF ROLL NO 86 :Properly explained with picture
REVIEW OF ROLL NO 87 :Properly explained with picture
REVIEW OF ROLL NO 89 :Properly explained 
REVIEW OF ROLL NO 91 :Properly explained 
REVIEW OF ROLL NO 92 :Properly explained with picture
REVIEW OF ROLL NO 93 :Properly explained with picture 

QUESTION 2 :What is finger escape ?

It is described as one of the signs of cervical cord damage .
It is deficient adduction and or extension of the ulnar 2-3 digits. 
It must be differentiated from similar looking signs affecting little finger include such as Wartenberg's sign 
To differentiate from these we need  to look for other signs of cervical myelopathy.





REVIEW OF ROLL NO 80 :Properly explained
REVIEW OF ROLL NO 81 :Not attempted
REVIEW OF ROLL NO 82 :Properly explained 
REVIEW OF ROLL NO 85 :Properly explained 
REVIEW OF ROLL NO 86 :Properly explained with picture
REVIEW OF ROLL NO 87 :Properly explained with picture 
REVIEW OF ROLL NO 89 :Properly explained
REVIEW OF ROLL NO 91 :Properly explained
REVIEW OF ROLL NO 92 :Properly explained with picture
REVIEW OF ROLL NO 93 :Properly explained with picture

QUESTION 3 :What is Hoffman’s reflex?]

Also known as digital reflex or snapping reflex.
Grasp the middle finger and flick the distal phalangeal joint. 
The test is considered positive if the Thumb shows adduction and index finger shows flexion. 
This is to test for pathological upper motor neuron reflexes seen in Cervical Myelopathy. 

 OF ROLL NO 80 :Properly explained with picture
REVIEW OF ROLL NO 81 :Not attempted
REVIEW OF ROLL NO 82 :Properly explained with picture
REVIEW OF ROLL NO 85 :Properly explained 
REVIEW OF ROLL NO 86 :Properly explained with picture
REVIEW OF ROLL NO 87 :Properly explained with picture
REVIEW OF ROLL NO 89 :Properly explained 
REVIEW OF ROLL NO 91 :Properly explained 
REVIEW OF ROLL NO 92 :Properly explained with picture
REVIEW OF ROLL NO 93 :Properly explained with picture 




H] LINK TO PATIENT DETAILS:


  
QUESTION 1 : What can be  the cause of her condition ?                             

REVIEW OF ROLL NO 80 :The cause is properly explained
REVIEW OF ROLL NO 81Not attempted
REVIEW OF ROLL NO 82 :The cause is not properly explained
REVIEW OF ROLL NO 85 :The cause is not properly explained
REVIEW OF ROLL NO 86 :The cause is properly explained
REVIEW OF ROLL NO 87 :The cause is properly explained
REVIEW OF ROLL NO 89 :The cause is properly explained
REVIEW OF ROLL NO 91 :The cause is properly explained
REVIEW OF ROLL NO 92 :The cause is properly explained
REVIEW OF ROLL NO 93 :The cause is properly explained 

QUESTION 2 :What are the risk factors for cortical vein thrombosis?

REVIEW OF ROLL NO 80 :Risk factors were explained 
REVIEW OF ROLL NO 81 :Not attempted
REVIEW OF ROLL NO 82 :Risk factors were explained 
REVIEW OF ROLL NO 85 :Risk factors were explained 
REVIEW OF ROLL NO 86 :Risk factors were explained 
REVIEW OF ROLL NO 87 :Risk factors were explained 
REVIEW OF ROLL NO 89 :Risk factors were explained 
REVIEW OF ROLL NO 91 :Risk factors were explained 
REVIEW OF ROLL NO 92 :Risk factors were explained 
REVIEW OF ROLL NO 93 :Risk factors were explained with diagrams

QUESTION 3 :There was seizure free period in between but again sudden episode of GTCS why ?resolved spontaneously  why?                           
 
REVIEW OF ROLL NO 80 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 81Not attempted
REVIEW OF ROLL NO 82 :Reason correctly answered and improperly explained 
REVIEW OF ROLL NO 85 :Reason correctly answered and improperly explained 
REVIEW OF ROLL NO 86 :Reason incorrectly answered and properly explained 
REVIEW OF ROLL NO 87 :Reason incorrectly answered and improperly explained 
REVIEW OF ROLL NO 89 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 91 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 92 :Reason correctly answered and properly explained 
REVIEW OF ROLL NO 93  :Reason correctly answered and properly explained 
            
QUESTION 4 : What drug was used in suspicion of cortical venous sinus thrombosis?

REVIEW OF ROLL NO 80 :Correctly answered
REVIEW OF ROLL NO 81Not attempted
REVIEW OF ROLL NO 82 :Correctly answered
REVIEW OF ROLL NO 85 :Correctly answered
REVIEW OF ROLL NO 86 :Correctly answered
REVIEW OF ROLL NO 87 :Correctly answered
REVIEW OF ROLL NO 89 :Correctly answered
REVIEW OF ROLL NO 91 :Correctly answered
REVIEW OF ROLL NO 92 :Correctly answered
REVIEW OF ROLL NO 93 :Correctly answered 


QUESTION 2 : MY CASE REPORT


CASE LINK: https://munukutlasaimythili.blogspot.com/2021/06/a-case-of-heart-failure-under-guidance.html



QUESTION 3 : 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 


CASE 1:


The above case can be considered complete because it has all the characteristics of a long case, from bio data, history proper to physical examination involving general and systemic examination and it ends with the treatment given and finally leading to the discharge summary .
However when it comes to the correctness of a case as a third semester student I do not have the required ability or knowledge to determine the rightness of a case apart from the history and normal pathological findings which as per my knowledge seem correct
When it comes to analyzing the uncertainties in therapeutics as we can see even through the discharge summary there are question marks indicating a uncertainty even though a number of diagnostic tests were run. We can see a concrete diagnosis could not be obtained
But with further increase in technology we can hope to further decrease these uncertainties



CASE 2:

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

The above case can be considered complete because it has all the characteristics of a long case, from bio data, history proper to physical examination involving general and systemic examination and it ends with the treatment given and the discharge summary with further advice .
However when it comes to the correctness of a case as a third semester student I do not have the required ability or knowledge to determine the rightness of a case apart from the history and normal pathological findings which as per my knowledge seem correct
This case gives us the importance of  diagnostic tools because even with examination we can say that the provisional diagnosis and the final diagnosis is quite different
Many uncertain issues arise during infectious disease such as finding out the specific organism which only gives certain tests and when we perform others it gives a negative

CASE 3


The above case can be considered complete because it has all the characteristics of a long case, from bio data, history proper to physical examination involving general and systemic examination and it ends with the treatment given and the discharge summary with further advice .
However when it comes to the correctness of a case as a third semester student I do not have the required ability or knowledge to determine the rightness of a case apart from the history and normal pathological findings which as per my knowledge seem correct
In this case additional date if admission is mentioned which gives us a breif idea about how long it took for control of the disease

CASE 4


The above case can be considered complete because it has all the characteristics of a long case, from bio data, history proper to physical examination involving general and systemic examination and it ends with the treatment given and the discharge summary with further advice .
However when it comes to the correctness of a case as a third semester student I do not have the required ability or knowledge to determine the rightness of a case apart from the history and normal pathological findings which as per my knowledge seem correct




CASE 5


The above case can be considered complete because it has all the characteristics of a long case, from bio data, history proper to physical examination involving general and systemic examination and it ends with the treatment given and the discharge summary with further advice .
However when it comes to the correctness of a case as a third semester student I do not have the required ability or knowledge to determine the rightness of a case apart from the history and normal pathological findings which as per my knowledge seem correct
As we can see in this case there was a requirement of many diagnostics to remove all the uncertainty regarding the diagnosis and hence the effective treatment of a patient


QUESTION 4 :Problem list for each patient and the diagnostic and therapeutic uncertainty around solving these problems.

CASE 1 :Problem list

We can differentiate the problems of the patient into 
A] Problems with which the patient arrived
*Backache
*Fever
*Jaundice
*Vomiting
*Burning micturation

B] Problems revealed in general examination
*Increased respiratory rate
*ABDOMEN :Scaphoid shape
                  Tenderness in right hypochondrium,epigastrium

C]Problems revealed while using diagnostic tools
*Decreased creatinine and sodium level
*Decreased pco2 and increased po2 due to increased rate of respiration
*Increased prothrombin time
* After joining it was found that 
   there is retention of urine and a palpable bladder
   Absence seizure which required a CT scan

The most reliable way of reducing the problems is to determine the  underlying cause and treat it
Even though you can reduce the symptoms it is not permanent and as long as the underlying cause is left untreated the patient will experience recurring symptoms 
Only when we know the problems can we formulate an action plan to reduce the problems
For the correction various drugs such as N Acetyl cyteine were given along with iv fluids were given

CASE 2 :Problem list

We can differentiate the problems of the patient into 
A] Problems with which the patient arrived
*Paraplegia
*Loss of hand grip
*Bowel and bladder incontinence
*Known case of TB on treatment regime

B] problems revealed in general examination
* Power of lower limb is slightly decreased and the lower limbs are highly decreased in paralysis
*multiple enlarged cervical lymph nodes

C]problems revealed while using diagnostic tools
*Increased blood urea
*Infectious spondylitis and cord edema
The underlying cause is identified and treated with  Inj. Optineuron and the previously existing disease TB is kept under control with ATT - according to body weight 2 tab PO/OD

 

CASE 3 :Problem list

We can differentiate the problems of the patient into 
A] Problems with which the patient arrived
*Complaint of Altered Sensorium
* Shortness of breath present even at rest .
* known case of Hypertension
*Known case of chronic kidney disease

B] problems revealed in general examination
* presence of oedema
* Dyspnea is present
* GROSS ASCITES
* Hypoactive, delayed response to commands

C]problems revealed while using diagnostic tools
Here we can see the worsening of symptoms of existing disease due to lack of prognosis of disease due to ignorance of patient

CASE 4 :Problem list 

We can differentiate the problems of the patient into 
A] Problems with which the patient arrived
* Distension of abdomen 
* shortness of breath

B] problems revealed in general examination
* Dyspnea is present grade three

C]problems revealed while using diagnostic tools
* ECG : Showing Atrial fibrillation
* 2D ECHO :Bilateral  pleural effusion
                    mild pericardial effusion.
* Normocytic normochromic Anemia
*Severe Hypothyroidism
Even though we could determine the diagnosis due to further underlying factors and lack of timely prevention we could not save the patient

CASE 5 :Problem list

We can differentiate the problems of the patient into 
A] Problems with which the patient arrived
* pedal edema 
* decreased urine output
* fever
* Acute kidney injury

B] problems revealed in general examination

* Bilateral edema pitting type
* pallor

C]problems revealed while using diagnostic tools
We can see that from complete urine examination , ECG, Ultrasound we can see the worsening of already existing ill ness that is Acute kidney disease



QUESTION 5 : MY LOG BOOK

Our clinical classes have started from 21 June and continuing


we have started our clinical class and have been briefed about the case history taking and many cases for referral
*our first case being about a 18M with Hemolysis ,coagulopathy and encephalopathy who came out of a coma after four days
*such cases which were an eye opening experience to us third semesters who are freshly entering into the world of clinicals 
*apart from that we learnt many diagnostic tools and pathophysiology of the above disease
* like this we have seen many cases each of which has its own story to teach with varying symptoms and many tests
*the online learning platform although a bit uncomfortable is enabling us to move forward even when the world around us comes to a stand still 
*we learnt about Multisystem Inflammatory Syndrome in children and there raise in number due to COVID 
*as such every day we a case which would help recap about history taking and teach us about various medications and thus connecting what we already learnt to what we will in future ensuring a competency based education.

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long case 2

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  This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome.                                                                                      With the help of our senior https://mvineelarollno90.blogspot.com/2023/11/65-y-female-with-co-fever-since-4-days.html I have been given this case to solve in an attempt 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 come up with diagnosis and treatment
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CHRONIC LEUKEMIA By Munukutla Sai Mythili 88     Shwetha Mummadi 87 INTRODUCTION Leukemia is cancer that starts in the blood-forming cells of the bone marrow. When one of these cells changes and becomes a leukemia cell, it no longer matures the way it should and grows out of control. Often, it divides to make new cells faster than normal. Leukemia cells also don't die when they should. This allows them to build up in the bone marrow, crowding out normal cells. At some point, leukemia cells leave the bone marrow and spill into the bloodstream. This increases the number of white blood cells in the blood. Once in the blood, leukemia cells can spread to other organs, where they can prevent other cells in the body from functioning normally. Leukemia is different from other types of cancer that start in organs like the lungs, colon, or breast and then spread to the bone marrow. Cancers that start elsewhere and then spread to the bone marrow are not leukemia. What is a chronic leukemia? I
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Hello everyone I'm mythili, an aspiring final year medical student presenting an osce report after garnering the patient informed consent Let's start off by learning the brief history about the patient A35 year old female came with cheif complaints of -Diminision of vision of right eye since morning 3am -Headache since 2 days Delving more into the history Patient was apparently asymptomatic 2 days back then started developing diffuse headache which was sudden in onset,gradually progressive associated with neckpain  No H/O nausea and vomiting,photophobia,phonophobia Then since morning 3am had sudden painless loss of vision No H/O ocular trauma or head trauma No H/O giddiness,LOC,weakness of both UL and LL No H/O fever,cough,cold,chestpain,palpitations,orthopnea,PND What was her last final diagnosis?  The final diagnosis  is CRVO Complete retinal venous occlusion  CRVO? How was the diagnosis made?  Upon opthological examination Dot blot hemorrhage Macular edema Which are characte
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