I, Vanshika Savla, a 3rd sem student of 2k19 batch have been given an assignment on general medicine.
QUESTION 1: Share your peer review of each answer with your quantitative marking input as well as qualitative insights into what was good or bad about the answer.
PULMONOLOGY CASE: A 55F with chief complaints of shortness of breath, pedal edema and facial puffiness.
> Roll no. 21
https://divyaraju266.blogspot.com/
Quantitative assessment: 9/10
https://divyaraju266.blogspot.com/
Quantitative assessment: 9/10
Qualitative assessment: The aetiology was explained very explicitly in a full circle along with a relatable image. The pharmacological interventions were sophisticatedly arranged explaining the site of action and the outcome accumulated. Evolution of symptomatology was not mentioned. It was good overall.
> Roll no. 42
https://gumudalavishal.blogspot.com/
Quantitative assessment: 8/10
> Roll no. 42
https://gumudalavishal.blogspot.com/
Quantitative assessment: 8/10
Qualitative assessment: Symptomatology was mentioned clearly. Primary aetiology could have been more precise and elaborate. It should have been inclusive of more details and other possible diagnostic findings. The work was appreciative.
CARDIOLOGY CASE:
1)patient details: https://muskaangoyal.blogspot.com/2021/05/a-78year-old-male-with-shortness-of.html
> Roll no. 46
https://jatinsharma46.blogspot.com/
Quantitative assessment: 7/10
CARDIOLOGY CASE:
1)patient details: https://muskaangoyal.blogspot.com/2021/05/a-78year-old-male-with-shortness-of.html
> Roll no. 46
https://jatinsharma46.blogspot.com/
Quantitative assessment: 7/10
Qualitative assessment: Informative and elaborate. Hypotension caused in case of anemia was not accurately described. A flow chart to discuss the complication would be more detailed.
2) patient details: https://muskaangoyal.blogspot.com/2021/05/a-73-year-old-male-patient-with-pedal.html
> Roll no. 19
https://preethicheera.blogspot.com/?m=1
Quantitative assessment: 9/10
2) patient details: https://muskaangoyal.blogspot.com/2021/05/a-73-year-old-male-patient-with-pedal.html
> Roll no. 19
https://preethicheera.blogspot.com/?m=1
Quantitative assessment: 9/10
Qualitative assessment: The information was precise and explicit. Very clearly explained the reasoning.
NEUROLOGY CASE:
> Roll no 24
NEUROLOGY CASE:
> Roll no 24
Quantitative assessment: 7/10
Qualitative assessment: Symptomatology was brief. If it were written in chronology with bullet points, it would have been more comprehensive. Statement for cause for neurological symptoms appearing for the first time is not bought up. Further complications are explained satisfactorily.
NEPHROLOGY CASE:
> Roll no. 138
Quantitative assessment: 10/10
Qualitative assessment: On the whole, the case study was very enlightening. It covered all necessary information from the progression of ADHD to the array of therapeutic methods with efficacy. It was brilliantly done.
> Roll no. 29
Quantitative assessment: 7/10
Qualitative assessment: A very vague and basic information is given regarding the topic. Everything is briefly explained. It could have been more descriptive.
> Roll no. 151
Quantitative assessment: 8/10
Qualitative assessment: Vague descriptive regarding is given. Although pharmacological interventions are properly put. Psychiatric conditions could be more elaborated.
GASTROENTEROLOGY CASE:
> Roll no. 18
Quantitative assessment: 9/10
Qualitative assessment: It has descriptive flowcharts with a detailed and elaborate content. The answer formatting is on point. It is very helpful for concise learning.
INFECTIOUS DISEASES (MUCORMYCOSIS):
> Roll no. 92
Quantitative assessment: 9/10
Qualitative assessment: The prevalent topic of mucormycosis was greatly put along with the statistics and crucial information. The drug action for treatment was explained with authentic diagrams.
QUESTION 2:
QUESTION 3: Provide your 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 shared.
CNS
A 28 year old male came with chief complaints of sudden fall followed by weakness of both the lower limb (paraplegia) and loss of hand grip 10 days back, associated with bowel and bladder incontinence.
Summary of the case:
History: Patient was tested positive for AFB bacilli a month back. This bacilli causes TB. Medications were taken for the same. Generalized weakness and myalgia was discovered 15 days back.
Systemic examination showed increased muscle tone with power of 1/5 in lower limbs.
Investigation findings: MRI scan of brain with cervical spine showed infectious spondylitis of C4, C5, C6, C7and D1 vertebral bodies with significant erosion at C5-C6 level. Epidural abscess was detected at C5-C6.
Diagnosis: Quadriparesis (muscle weakness in all 4 limbs) resulting from epidural abscess at C5-C6 level.
Views: Chronological arrangement of details. Accurate investigations were done in accordance with the presenting illness. Symptoms of the patient could have been elaborate. Investigation findings did not include MRI scan images to review it. On the whole, it had all the necessary information required for diagnosis.
QUESTION 4: Provide your 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 shared.
ABDOMINAL
A 60yr old female presented to the OPD with chief complaints of pedal edema since 10 days, decreased urine output since 10 days and fever since 10 days.
Summary of the case:
The patient was diagnosed with DM2 5 years back. She developed fever, shortness of breath and pedal edema which was diagnosed with Acute kidney injury secondary to Urosepsis, 2 years ago. 10 days back, patient was presented with high grade fever with complaints of pitting pedal edema, decreased urine output and burning micturition.
General examinations show pallor with generalized lymphadenopathy
Vitals reveal high pulse rate, high blood pressure and low oxygen saturation.
Systemic examination did not reveal anything.
Investigations reveal high creatinine and blood urea level. Hyperkalemia is observed. ABG reveals metabolic acidosis.
Reports show presence of Candida spp. causing yeast buddings. This may have caused urine tract infection leading to acute kidney injury. The fungal growth was eliminated with proper medication and incubation and frequent susceptibility testing.
Views: The investigation reports were updated daily until 23/06/21 with treatments and investigations undergoing day to day. It wasn't updated since then. No further input whether the patient is discharged or still under incubation is given. Ultrasound images were not provided to appreciate the kidney dysfunction. Overall, it had good elements of data.
QUESTION 5: Testing scholarship competency in logging reflective observations on your concrete experiences of this last month.
Missing out on clinical postings is something we were all concerned about ever since the pandemic erupted. I've heard from seniors about how interrogative and newsy these sessions are and it was impressive and exciting to hear.
Recently, there was an initiative to start clinical postings for us online with efforts of Dr. Biswas sir and the interns. We were shown variety of patients on camera and cases were discussed among the interns. Almost more than 10 patients were covered through in one class. Although, we are sure offline classes would help us stay attended, these sessions are not far from it. The concept of telemedicine needs to be appreciated here as it has capacity to help us establish a base on thorough analysis of cases with diverse learning.
There has been a few notable technical issues like audio error and poor connection which could be fixed for a better learning.
All inclusive, this early teaching through virtual means will surely pay off for our diagnostic abilities and decision making.
- END -
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