OSCE

-
General Medicine OSCE with real patient 

Introduction: This online E-log Entry Blog is an objectively structured clinical examination method to assess the clinical competence during the course of my General Medicine Internship rotation (June'2023-August'2023) by reviewing the case reports shared below and to discuss, understand and review the clinical scenarios and data analysis of patients so as to develop my clinical competency in comprehending clinical cases, and providing evidence-based inputs for questions surrounding the clinical vignettes borrowed from the E Log Book.

Note: The cases have been shared after taking consent from the patient/guardian. All names and other identifiers have been removed to secure and respect the privacy of the patient and the family.

CASE REPORT -1: 

A 14 year old female presented to casualty with C/O SOB since 2 hours,sudden onset ,grade 4 .No orthopnea and PND .Fever since 8 hours ,high grade a/w chills and rigors .Rash over the abdomen since 3 days ,no itching or redness,no discharge ,no pain


https://lasyasakilam27.blogspot.com/2023/07/diabetic-ketoacidos.html


Q>What is the given skin lesion and how can it be treated? 


It is most likely post inflammatory hyperpigmentation 

Treatment: Oint T Bact L/A 

                      Venusia max lotion L/A

Q>What are the causes of DKA ?

Diabetic ketoacidosis (DKA) is primarily caused by a lack of insulin in the body, which leads to high blood sugar levels and the breakdown of fats for energy. This breakdown produces ketones, resulting in the acidic environment seen in DKA. It's often triggered by factors like infections, missed insulin doses, illness, or stress.



Q>What is the Treatment protocol for DKA ?



Q>What is the cause of DKA in this patient ?

--The rash could probably indicate underlying infection which triggered the DKA 

--Patient's non compliance to treatment could also have led to this current state, i. e. 

Woke up at 7 am 

Missed the morning dose of insulin and breakfast because she was late to school 

Went to school at 8 am 

Felt giddiness and told the Teacher about it. Teacher asked her to eat. 

Refused to eat due to nausea 

Had Vomiting at 11 pm - water content 

At 12:30 vomited once again - water content 

Informed her grandfather and went home at 1 pm

At home she started developing SOB so didn't eat again

Went to local doctor due to SOB at 5 pm

She was put on O2 there and when it didn't resolve the doctor advice to go to higher centre 

Came to kamineni at 7:30 pm 




Comments

Post a Comment

Popular posts from this blog

A 14 year old female with SOB snd fever

-
Image
    This is online E log book to discuss out patients de-identified health data shared after taking his / her guardian`s informed consent. Here we discuss our individual patient`s problems through series of inputs from available global online community of experts with an aim to solve patients clinical problems with collective current best evidence based inputs.       This E log book also reflects my patient centered online learning portfolio and your valuable inputs on comments box is welcome . Note:  The cases have been shared after taking consent from the patient/guardian. All  names and other identifiers have been removed to secure and respect the privacy of the patient and the family. Consent:   An informed consent has been taken from the patient in the presence of the family attenders and other witnesses as well and the document has been conserved securely for future references Patient came to casualty with C/O: 1) Shortness of brea...
Read more

Medicine Internal assessment

-
Image
10 Marks questions: Question - 1  Define bone density, how is it measured? What are the causes, clinical features,diagnosis and management of osteoporosis? (1+2+2+2+3) https://rishik37.blogspot.com/ 2021/08/gm-elog-case-7.html  ( 31st aug, 3:39pm) Question - 2   What is myxedema coma? Describe its clinical features , diagnosis and treatment of myxedema coma (2+2+2+4)   http://mahithguduri63. blogspot.com/2021/09/myxedema- coma.html(  22nd sep, 9:36am) 4 marks questions : Question - 3  What is the diagnostic approach of young onset hypertension and it’s treatment. http://keerthykasa80.blogspot. com/2021/09/a-35-year-old- female-with-hypertensive.html( 22nd  sep, 10:24am ) Question - 4  How do you clinically localize the anatomical level of lesion in spinal cord diseases. http://sowmya9.blogspot.com/ 2021/08/21-year-old-with.html( 2nd  sep, 7:27pm)   Question - 5  C auses,diagnosis and treatment of atrial fibrillation. (Shared on 25th...
Read more

A 56 year old male with altered sensorium and CKD

-
Image
A 56 Yr old male R/o Miryalaguda,  dialy labourer by occupation came to hospital on 19 November 2021 for his dialysis  Hopi :  Patient was apparently asymptomatic 2 years back when he was diagnosed with CKD when he had c/o bilateral pedal edema  Patient has come to the hospital for his regular dialysis session on 19 Nov, after running regular tests he was told he requires blood transfusion.  Dialysis session was delayed due to blood transfusion ( the last dialysis session was 14 days back).  Patient developed fever since 3 days associated with chills and rigors and increased during night. No associated vomiting, diarrhea, shortness of breath.  Patient's relative noticed slurring of speech and not responding to commands since 1 day  Past history :  H/o hypertension and diabetes mellitus since 4 years.  Diagnosed with CKD 2 years back, for which he is on dialysis twice a week  H/o blood transfusions 2 times in the past, recent one is ...
Read more