Intern online assessment

 Duration of posting (12/10/22 to 11/12/22)

During units duty:

1. Inserted foley's catether twice

2. Inserted ryle's tube twice

3. Tried ascitic tapping in an abdominal distended patient with ascites present in ICU

4. Took ABG samples and collected venous blood samples for routine investigations

Case 1:

https://manogna33.blogspot.com/2022/10/chronic-liver-disease-with-akihepato.html

My orientation around the case

1. What is the possible cause of his pedal edema?

Renal impairment or low output states (Cardiac failure) or acute tubular atrophy

2. What is the cause of nil urine output in this patient

Hypotension and hypovolemia are the two most important causes of decreased renal perfusion

In this patient, when he came to the casualty his BP recorded was 60/40 mmHg

3. What are the indications for commencing dialysis in this patient

a. Urine output <0.3 ml/kg for 24 hours

b. Absolute anuria for > 12 hrs

c. Multiorgan failure

d. Refractory volume overload

e. Complications of uraemia

- Uraemic encephalopathy

- Uraemic pericarditis

Case 2:

https://manogna33.blogspot.com/2022/10/80-year-old-male-with-fever-and-burning.html

My orientation around the case

1. What is the cause of urinary incontinence in this patient

Most probably the cause for urinary incontinence is Urinary tract infection

In this patient polymicrobial flora growth is seen

2. What is the cause of lower limb weakness in this patient

Most probable cause in this patient is due to epidural collections behind D8 and D9 vertebral columns and disc degenerative changes at all levels

Case 3:

https://manogna33.blogspot.com/2022/10/45-year-old-male.html

My orientation around the case

1. What is the main cause of stroke in this patient

The most possible cause of stroke in this patient is chronic smoking

2. What is the cause of blurring of vision in this patient

A decreased blood supply prevents the brain tissue from getting oxygen and nutrients. This blockage can have widespread effects on the body, depending on the affected area of the brain leading to vision problems

Case 4:

https://manogna33.blogspot.com/2022/10/60-year-old-male.html

My orientation around the case:

1. What causes decreased platelet count in this patient

Most possible cause of decreased platelet count in this patient is viral infection (viral hepatitis) leading to systemic inflammation, which in turn triggers platelet activation and decreases platelet lifespan

Case 5:

https://manogna33.blogspot.com/2022/10/40-year-old-female.html

My orientation around the case

1. How does fever occur

Fever occurs as the hypothalamus increases or raises body temperature of the body

Case 6:

https://manogna33.blogspot.com/2022/10/24-year-old-male.html

My orientation around the case

1. What is the cause of decreased platelet count in this case

The most probable cause of decreased platelet count in this case is NS1 positive

Case 7:

https://manogna33.blogspot.com/2022/11/44-year-old-male.html

CPR done when the patient has been cardiac arrested

ICU duties

1. Watched central line procedure and done suturing

2. Inserted foley's catheter twice

3. Inserted ryle's tube twice

4. CPR done in cardiac arrested patients thrice

5. Took ABG samples and other venous blood samples for routine blood investigations

6. Monitored vitals of the patients

Ward duties

1. Attended clinical lecture hall discussions and recorded videos

2. Helped our long distance patients by taking them to referrals

3. Monitored vitals of the patients

Psychiatry

1. Learnt how to take history taking in psychiatry

2. Seen cases of alcohol dependence syndrome

3. Seen cases of depression

4. Seen case of schizophrenia

5. Seen case of emotional jealousy

6. Understood the importance of mental health 

7. Visited DAC and seen patients how they do their daily activities and their time table