MY EXPERIENCES WITH GENERAL CELLULAR AND NEURAL CELLULAR PATHOLOGY IN A CASE BASED BLENDED LEARNING ECOSYSTEM'S CBBLE "

 

"MY EXPERIENCES WITH GENERAL CELLULAR AND NEURAL CELLULAR PATHOLOGY IN A CASE BASED BLENDED LEARNING ECOSYSTEM'S CBBLE "




I am N.Vinil Reddy an intern at Kamineni Institute of Medical Sciences. This is an e log where I discuss about the various cases I have seen during my UG and internship period .


CBBLE PAJR PARTICIPATORY LEARNING ACTION RESEARCH DISCLAIMER

 NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS/HER GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT. 



My first case and experience about a 58 yr male with c/o swelling of B/L lower limbs .


My first patient interaction had occurred during the medicine postings of 3rd semester. There is a 58yr old male patient lying on the bed in the nephrology ward , after introducing myself ,I proceeded to ask about the complaints of the patient . He complains of swelling of both lower limbs

Since 1week . He also complains of shortness of breath . 

He is a known case of chronic renal failure for which he undergone 6-9 sessions of hemodialysis .

On examination I had come to know that he also has pallor .


He is on tab. Nodosis 500mg Po/BD , tab arkamin 0.1 mg Po/BD for HTN, tab shelcal 500mg Po/OD 


As a 3rd sem student i had limited knowledge and had doubts related to all the history given by him and their inter relations so i had went through some of the online sources which had given me a knowledge regarding them.


My learning :

because of this patient I had learnt that swelling of legs and shortness of breath are the symptoms of CRF . And also I had searched about the differentials for the given symptoms and I get to know that these symptoms can also be seen in Heart failure patients . I also learnt about the importance of the history taking and how to interact with the patient . I had also learnt about the importance of hemodialysis and complications of dialysis.


Case link of the above mentioned case :


https://vinilreddynallamdompallyrollno101.blogspot.com/2022/08/55-yr-old-patient-named-p.html



A 80 YR OLD MALE PAYIENT WITH C/O FEVER SINCE 8 DAYS AND DRU COUGH SINCE 5 DAYS.


This is a case of 80yr male patient came to opd with c/o fever and dry cough 

Fever is of low grade type and it is on and off and it is not associated with chills and rigor . After which he developed dry cough . Not associated with difficulty in breathing.  As fever and dry cough can occur due to lung infections like pneumonia we had sent for chest x ray which came out as normal . On seeing his cbp report I had come to know that his platelets counts are low . On seeing this we had sent investigations for dengue infection which came out to be negative .

This patient is diagnosed as viral pyrexia with thrombocytopenia. 


My learning : I had learnt that  even though there is thrombocytopenia it is not necessarily mean dengue infection as I thought in my 1st year. 

I also came to know about the causes of the thrombocytopenia . And I also learnt about the different types of fever like continuous or intermittent fever , low grade or high grade fever malarial or typhoid fever etc.. 


For further details regarding the case plaese visit below link : 


https://vinilreddynallamdompallyrollno101.blogspot.com/2022/08/this-is-online-e-blog-to-discuss-our.html



A 55 year old male patient  construction  worker by occupation resident of nalgonda  came to opd with chief complaints  of
 fever since 14 days , Breathlessness since 7 days ,Right side chest pain- 7days



This is a case of 55yr old male patient with c/o fever since 14 days , breathlessness since 7 days , right side chest pain since 7 days .

Fever is of insidious in onset and gradually progressive, on and off type not associated with chills and rigor . Also complains of breathlessness which is insidious in onset and gradually progressive and relieved on lying to left . Also complains of right sided chest pain which is intensified on deep inspiration . Complains of non productive cough since 7 days . he was diagnosed has pleural effusion .


He was examined and investigations are done . 

On examination there is the shift of tracheal position to right , stony dullness in the left infraclavicular and mammary region . 

On x ray there is loss of costophrenic angle .

Pleural tap was done for this patient : 

Pleural tap: 

 Volume 2ml 

Colour yellow 

Appearence clear 

Cells 160cells/cc


Pleural fluid ADA :28U/L


Lights criteria :
Fluid protein /serum protein : 5.6/7.9 =o.7 ( criteria:>0.5)
Fluid LDH /serum LDH :259/174=1.4
Pleral LDH: >2/3rd serum ldh 

My learning: from this patient I had learnt about the causes of pleural effusion and also learnt how to diagnose pleural effusion from the chest x ray . In pleural effusion there is loss of the costophrenic angle . I also learnt about how to distinguish b/w exudative and transudative pleural effusion by using the lights criteria .
For further details please visit below link : 


I had also taken other cases like heart failure , urosepsis with uti , alcoholic hepatitis etc.. for the details about those cases please visit below link . 










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