110 Ramavath Gopal Krishna

         General Medicine Assignment
 
                               Renal Failure Cases
2019 Batch (3rd semester)
R.Gopal Krishna 
Roll Number :110.
              
Iam Gopal krishna from 3rd semester of roll number 110 was given following assessment to review and analyze the elogs and the clinical cases .The system of learning in the healthcare system purely reflects the theme "scholarship of integration in the medical education and research "

Question 1:
                 Peer Review:
I want to share the preview of  Sumanthraj roll 109  ,the link is given below

  1. He gone through each every blog very carefully and gave a complete preview.Eventhough the reviews are short but its worthy.
2.He covered in various sectors like pulmonology,cardiology,gastrentology etc.. and gave a decent peer reviews
3.The final output was very good.It could be more impressive if he highlights the main headings.

Question 2:
 Below is the link of my case report of a patient that I`ve connected with and engaged while capturing his sequential life events before and after the illness and clinical and investigational images along with discussion of that case.

Question 3:

a.AKI
Patient admitted hospital with sudden onset of pain in abdomen (by wieght lifting) and also burning micturition with highfever associated with chills and rigor. 
The patient is diagnosed as Acute Kidney Infection secondary to Urinary Tract Infection.
This  blog is well described and updated all the necessities.

b.Acute on CKD 

The e-log is very informative  and easy to comprehend the points.
The points are precised and well written.

c.CKD

->Various investigations like LFT,2D Echo,bone marrow aspiration test etc are done which are helpful in probable diagnosis
->The e-log is presented in systemic manner

d.PATIENT WITH RENAL FAILURE:


->The points are precised and well written.
->The usage of highlighted texts made the information clear.
->Placement of pictures and reports are good.

e.AKI


->The process of general examination is well mannered.
->All the process are in order.
->Overall e-log is well described.


->The history of patient is well explained.
->The daily treatment history and medications for urosepis also arranged in well mannered.

⇒Pancreatitis occured due to chronic alcholism. Many investigations are done including ultrasound to get a detailed view of the liver and if condition due to alcholism.

Question 4:

✱ Case 1
Diagnosis : AKI  secondary to UTI, associated with Denovo - DM -2 
Treatment : 
1)IVF : -RL  @ UO+ 30ml/hr -NS
2)SALT RESTRICTION  < 2.4gm/day
3)INJ    TAZAR    4.5gm  IV/TID
                                 |
                             2.25gm IV/ TID
4)INJ     PANTOP 40mg  IV/OD
5)INJ     THIAMINE  1AMP  IN  100ml   NS   IV/TID


✱Case 2
Diagnosis : Hyperuricemia 2° to Renal failure 
Treatment:
• IVF -    NS-0.9%  @100ml/hr
• Inj. Tazar 2.25gm I.V -TID 
• Inj. Lasik 40mg I.V -BD 

✱Case 3
Diagnosis:  Chronic interstitial nephritis secondary to plasma cell dyscariasis
Treatment:   
- T. PAN 40mg /PO / OD
- oral fluids upto 1.5 - 2 lit / day
- Protein - x ( plant based ) 2 tablespoon   in 1 glass of  milk  

✱Case 4
Diagnosis: DKA with AKI 
Treatment:
Inj. NORAD 2amp in 50ml NS
Inj. PIPTAZ 2.25gm.
Inj. DOPAMINE 2amp in 50ml
Inj. HAI 1ml in 39ml NS

✱Case 5
Diagnosis:INFECTIVE ENDOCARDITIS
Treatment:
1. Inj. Monocef 1gm IV/BD
2. Inj. Vancomycin 500mg IV/BD in 100ml NS over 1hr
3. Procto clysis enema
4. Inj. Pan 40 mg Iv/OD

✱Case 6 
Diagnosis: Renal AKI secondary to urosepsis with b/L hydroureteronephrosis
Treatment: 
Injection PANTOP 40mg IV/OD
Injection PIPTAZ  4.5 stat  and 2.25 gm  IV/ TID
Injection LASIX 40mg IV/BD
Injection optineuron 1AMP in 100ml NS slow IV/OD

✱Case 7
Diagnosis: HFrEF secondary to CAD; CRF
Treatment: 
1. TAB. BISOPROLOL 5mg OD
2.TAB. NITROHART 20/37.5mg 1/2 T/D
3.TAB NICARDIA XL 30mg OD
4.TAB. GLICIAZIDE 80mg BD
5.TAB. NODOSIS 500 mg TD

✱Case 8
Diagnosis: Acute on CKD 
Treatment: 
1. Tab. Augmentin 625 mg ×7 days
2. Tab. Wysolone 40 mg ×10 days.
    30 mg × 10 days 
    20 mg ×10 days
    10 mg ×10 days.
3. Tab . Lasix 20 mg  × 1 month.

✱Case 9
Diagnosis: Alcoholic Hepatitis and aki sec to gastroenteritis
Treatment: 
INJ THIAMINE 100 mg in 100 ml NS slow IV / TID
INJ OPTINEURON 1AMP in 100 ml NS slow IV / OD
INJ LASIX 40 mg  
     

✱Case 10
Diagnosis: Acute Kidney Injury secondary to Urosepsis
Treatment:
 Inj LASIX 40mg (8am- 2pm -8pm)
IVF - NS @ UO + 50 ml/hr

✱Case 11
Diagnosis: pancreatitis in a chronic alcoholic 
Treatment:
IV lasix  40 mg BD .
Tab Nodosis .
IV PIPTAZ 4.5 Gms. BD 
Iv 25%Dextrose. 100 ml BD 
Iv fluids : NS 40 ml /hr.

Question 5:
  
Its really a tough thing during this pandamic situation to conduct both an offline and online classes.By anyhow our faculties are conducting online classes.It is helpful but not as much as offline classes.
As a medical student clinical knowledge is more important to us(3rd semester) but in this epidemic it's not possible to gain as efficient as in offline postings.In online This assignment has helped me to learn the basics of clinical practice like history taking, presentation of the case and how to approach a patient, etc ,. we are trying our best to understand the subjects.I really thank for all the efforts made by our institution and General Medicine department and our PG's and interns




                         THANK YOU

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