YADAVALLI JAYA SRUJANA
GENERAL MEDICINE MONTHLY ASSESSMENT
This is online elog book to discuss our patient's de-identified health data shared after taking his /her /guardians signed informed consent. Here we disuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs.
Q1
LONG QUESTION-
The case is very well presented with abundant information about the patient's condition. The history taking is descriptive and easy to understand. The photographs provided helped me to understand the condition of the patient. I think it would be better if the information about the patient was written in point wise manners rather . Overall, the case is well phrased.
1 SHORT QUESTION-
The presentation is short and to the point. Well informative about the patient's health condition.will suggest to add more pictures and flowcharts
2 SHORT QUESTION-
Well written and Informative.helpful pictures of the patient's opd pictures. Easier to Understand and learn from this case presentation.
Q2
Long case:
Patient's problems-
Facial Puffiness
Pedal edema
Severe joint paints including feet wrist hands
Limitation of moments of joints
Burning sensation of eyes
Subcutaneous swellings
Involuntary loss. Of weight and apetite
TREATMENT-
- Free water restriction for Hyponatremia
- Tab. PREDNISOLONE P/O 20 mg OD
- Tab FEBUXOSTAT P/O 80 mg OD
- Haemodialysis for worsening renal dysfunction
SHORT CASE 1-
patients problems:
progressive asymmetric involuntary movements of his right index and middle fingers
stiffness in his wrists (Right>Left), which has now ascended to his elbows.
constipation
loss of sexual desire
TREATMENT-
1. Tab. Syndopa Plus 125 mg QID
2. Tab. Syndopa 125 mg CR OD
3. Tab. Telma 40 mg OD
2 short case-
Patient's problem:
Itchy rings Over multiple parts of the body
Multiple purple marks on abdomen upper limb
Abdominal distension and Facial puffiness
Weight gain
Loss libido
Pedal Edema
TREATMENT-
On 3/6/21 - ACTH STIMULATION TEST WAS DONE .
BY INJECTING 0.4 ML OF ACTOM PROLONGATUM INJECTION (ACTH) INTRA MUSCULAR @ 7am
1 HR LATER FASTING SERUM CORTISOL SAMPLE WAS SENT .
VALUE - 0.73 mcg/dl
Indicating there was HPA AXIS suppression and pt was started on TAB HIZONE 15 mg per day in three divided doses @ 8am ,12 pm and 4 pm.
Dose of Tab hizone was reduced to 10 mg per day in divided doses for one month.
In view of low back ache Xray LS spine was done which was normal and pt was advised.:
Tab Shelcal 500 OD and Tab Vit D 3 Od.
Tab ULTRACET /PO/SOS.
Q3
The time line of treatment of the patient is helped in understanding how the prognosis of their condition is. The flow charts, the images are well taken .
Q4
Did not get the opportunity to interact with the patient and take history.
Q5
During these hard times, the online case taking has been really helpful. These are well written and descriptive. The concepts are easier to grasp with help of the images and YouTube links provided in the blog. Will be eagerly waiting to attend clinical postings and to interact with patients.
