GM assignment 1
Medicine paper for June 2021 bimonthly blended assessment
I am Tvisha D., a second year MBBS student (3rd semester).
This is an assignment that I've worked on based on my experience of clinicals, doctor-patient interactions that I've witnessed and E- logs made by my seniors that I've referred to.
Here's the link to the questions that I've answered below:
This blog is divided in to 4 sections, with answers to 5 questions.
Brief description of the sections:
1. Summary and review of clinical cases.
2. Patient history that I've taken after studying a case.
3. Case study: my understanding of the investigative process and critical appraisal of the case in question.
4. Reflective observations on my first month of clinical exposure.
Section 1
Q1) Reviews on 10 Submissions for a clinical case.
A1) Pulmonology case:
case briefing:
55 year old female with shortness of breath, pedal edema and facial puffiness.
The patient suffered from yearly attacks of SOB lasting nearly a month for the past 12 years with history of hypertension (diagnosed 20 days earlier) and diabetes (diagnosed 8 years earlier).
I feel the diagnosis made rightly indicates the possibility of a pollen allergy. I don't think the cause could be the usage of chulha given the pattern of SOB attacks.
The interventions, suggested are very good. Reasons cited for acute exacerbation and electrolyte imbalance are plausible.
Score: 4/5
Answers are well written and are very informative. Point wise approach of presenting answers would've made understanding easier. Answer on effects of ATT could be elaborated on. Other answers were explained competently especially the answer on treatment.
Score: 4/5
Pictures (charts) used made understanding the topic easier and better, question on treatment and medication was answered and presented well. Answers c and d could be written in more detail. Overall, it was crisp, informative and easy to navigate through.
Score: 4/5
Evolution of symptomatology was well compiled but the diagnosis seems to be incomplete. Answers 2, 3 and 4 could be written much better, they seem to lack a lot of information. Answer 5 is missing. Overall answers and presentation need to be worked on.
Score: 2.5/5
Answers are well written and detailed. However, presentation could be more spaced out and organized. Answer 2 regarding interventions was explained well. Other answers citing causes for acute exacerbation, electrolyte imbalance and effects of ATT on symptoms were apt.
Score: 4/5
Answer 1 and 2 are well presented but answers 3 and 5 are incomplete and lack organization. Answer 4 is missing. Usage of pictures would be appreciated.
Score: 2/5
Answers are very well written, presentation is organized and made navigating through the work easier. Point wise approach and flow charts made understanding the topic interesting and easy.
Score: 4.5/5
Answers are short and crisp. Sentences were spaced out a lot which disrupted continuity in reading. Answers 2, 3 and 4 are incomplete. Answer 5 is missing.
Score: 2/5
Answers are well written. Point wise approach of answering and organized presentation made the work interesting and easy to understand. Answers 4 and 5 could be explained in detail.
Score: 4/5
Answers are very well written and are very informative. Chart made for first answer is very good. Organized presentation and pictures used helped in going through and understanding the work better. Questions 3, 4 and 5 were well answered.
Score: 4.5/5
Section 2
Q2) E-log of clinical case
A2) Blog link
Given below is a link to my first General Medicine E-log.
The patient was diagnosed with CVA with acute infarct.
Working on this case has given me insight into the process of history taking of a patient, investigations carried out and treatment provided.
Section 3
Q3) My understanding of and critical appraisal of an E-log.
Link to the log I used for my answer:
A3) CNS Case Summary:
Patient (28, M) came with complaints of weakness of both limbs (paraplegia) and loss of hand grip associated with bowel and bladder incontinence after suffering a sudden fall.
Sputum studies following productive cough and low grade fever showed positive results for AFB bacilli.
Patient developed generalized weakness and myalgia. He is a known case of TB and is on ATT.
There are no signs of sensory impairment.
A4) Critical Appraisal of Case:
Positives:
The case is very well presented.
History taken has presented under headings of history of present illness, history of past illness(es), personal history and family history. This gives us an insight into the patient's medical history and current medical problems.
Results of general and systemic examination were also presented.
Pictures added to the log helped understand the case better.
Mention of provisional diagnosis (of cervical myelopathy or potts spine) and final diagnosis of (Quadreparesis secondary to infectious spondylitis of C4, C5, C6, C7 and D1 with epidural abscess at C5-C6 level) helped understand the line of thought behind diagnosing the disorder. Pictures of the investigation results also gave a good understanding of the case.
Negetives:
If the pictures attached were labeled and the problem was circled in the pictures, it would've been more helpful.
Overall, this experience of going through an E-log helped me understand the neurological disorder.
Section 4
Q5) Reflective observations on my experience of attending clinicals:
A5)
Amidst the second wave of the raging pandemic in India, batch of 2019 entered the second year of MBBS. Unlike our seniors, we didn't get the opportunity to see the patients in person, given the special circumstances.
For the entire month of June, we attended classes and clinical postings online. The first month of clinical exposure was unlike anything I've experienced. Though it was hard for our lecturers to help us experience clinical postings virtually, the sessions were very interesting.
We got to see the doctors and interns interact with the patients. The lecturers explained a variety of cases and the sessions were interactive and involved our participation.
In OB-GYN clinicals, we focused on one patient and interacted with them personally by asking questions. In General Medicine clinicals our lecturers showed us many patients admitted in the hospital and made the session interactive by asking our opinions on the case and diagnoses.
Overall, the experience though online and virtual was very interesting, informative and enlightening. I am looking forward to attending clinicals offline and interacting with the patients and doctors in person.
I am grateful to the doctors, interns, PGs and IT staff for making online clinical classes possible.
Thank you for going through my blog!
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