Internship Assessment

 12/10/22 to 19/10/22

ICU & AMC DUTY:

-  Monitored vitals of all pts hourly 
-  Maintenance of ventilator settings as guided by the respective PG.
-  Taken ABGs and have taken samples for lab investigations.
-  Learnt how to manage in critical situations 
-  Assisted in intubation and central line 
-  Ryles have been put for 2 patients 
-  CPR done for 2 patients 
-  Foleys have been put for 3 patients 
-  Assisted surgery pg in bed sore dressing 
- Have done ulcer dressing for 1 patient 
-Assisted in doing and done Ascitic tap 

20/10/22 to 23/10/22 
 
NEPHRO DUTY:


-  monitored patients who came for dialysis 
-  Handled Day care patients who came for dialysis. 
-  Learnt about dialysis machine and what all infections a pt can get by not maintaining proper hygiene of the central line 
-  Learnt about central line and fistula for dialysis.
- Have removed 3 patients central line 
-  Assisted my PG in putting central line 
-Have learnt how to give NTG to the patients and gave for 3 patients 
-  Have learnt how to maintain patients BP and GRBS while dialysis is going on
-  Learnt about drugs used in hypo and hypertension.

24/10/22 to 26/10/22

WARD DUTY :

-  Helped my co interns in putting SOAP notes
-  Have put cannulas and taken samples of ward patients
-  Monitored patients in the ward as guided by concerned unit PG and helped them by updating the ward patients. 
-  Have helped PG in his thesis of Fat to Muscle ratio 

Procedure: 

For mid arm circumference we measured from acromian process to olecrenon process and took the midway measurement between the two bony points And then measured the skin fold thickness with our callipers and then subtracted the mid arm circumference with the callipers value to get our muscle mass.For Visceral fat we took umbilicus as our reference and measured it’s girth After getting both values we divided visceral fat with Mac(mac-skinfold thickness) to get our ratio.







27/10/22 to 11/11/22
 
PSYCHIATRY POSTING:


PSYCHIATRY DUTY:

-  Learned about importance of history taking and how by history we can reach to a provisional diagnosis.

-  Saw different patients and learned how to take basic history 

Examples like :

1. Schizophrenia 

2.OCD

3.ALCOHOL DEPENDENCE SYNDROME 

4. TOBBACO DEPENDENCE SYNDROME 

5. Depression 

6. Psychosis 

7. Panic attack 

-  learnt the medications given to the patients and their side effects

-  Went for DAC saw how pgs interact with the patients 

12/11/22 to 11/12/22

UNIT DUTIES :


1) https://chippaakhila23.blogspot.com/2022/11/28year-old-female-with-pyelonephritis.html

- patient came to OPD with fever history since 3 days then patients investigations were sent and usg showed pyelonephritis 

1) Triad of pyelonephritis?

     Loin pain , fever, tenderness over kidney region 


2) Cause of fever which was continuous and not got subsided for  a 4 days ?

  PYELONEPHRITIS 

   We thought  Cause of the fever could be pyelonephritis and started her on antibiotic zostum 1.5g but her symptoms were not subsided so we took urology referral where they suggested to put on piptaz 4.5 g then after 3 days her fever got subsided

2) https://chippaakhila23.blogspot.com/2022/11/35-year-female-with-vertigo-secondary.html

1) cause of her Dizziness and headache?

     BPPV 

Dix hallpick manoeuvre was done -positive 

Done epleys manoeuvre where patient felt relieved 

 




3) https://chippaakhila23.blogspot.com/2022/11/65-year-old-female-with-pyrexia-with.html

What is cause of abdominal Pain in dengue ?

-  Gastric erosions or ulcer , acute hepatitis Gall bladder thickening ,acute a calculus cholecystitis, acute pancreatitis 


https://apps.who.int/iris/bitstream/handle/10665/164137/dbv29p85.pdf;sequence=1

1)What is the criteria to diagnose dengue ?

The criteria for diagnosing probable dengue fever are living in or travel to a dengue endemic area, fever and two of the following criteria: nausea, vomiting, rash, aches, a positive tourniquet test, leukopenia and any warning sign. The warning signs are abdominal pain or tenderness, persistent vomiting, clinical fluid accumulation, mucosal bleeding, lethargy, restlessness, liver enlargement of >2cm and increase in haematocrit concurrent with a rapid decrease in platelet count. 

2)What are the indications for platelet transfusion?

Indications for platelet transfusion :
-Platelet transfusion is not the mainstay of treatment in patients with DF. In general, there is no need to give prophylactic platelets even if at platelet count >10 000/mm3.
-Prophylactic platelet transfusion may be given at levels of <10 000/mm3 in the absence of bleeding manifestations
-Haemorrhage with or without thrombocytopenia- transfuse platelet
- Prolonged shock with coagulopathy and abnormal coagulogram
-In case of systemic bleeding, platelet transfusion may be needed in addition to red cell
transfusion. Whole fresh blood transfusion doesn’t have any role in managing thrombocytopenia.


3)Criteria to discharge dengue patient ?

The admitted patients who have recovered from acute dengue infection with visible clinical improvement having no fever forat least 24 - 48 hours, normal blood pressure, no respiratory distress from pleural effusion or ascites, improvement in clinical status (general well-being, return of appetite, adequate urine output, no respiratory distress),persistent platelet count >50,000/cu.mm should be discharged from hospital









Comments

Post a Comment

Popular posts from this blog

35 year female with vertigo secondary to bppv

Image
  This is an online E log book 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 series of inputs from available global online community of experts with an aim to solve those patient's 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 the comment box  chief complaints: HEADACHE SINCE 11 YEARS GIDDINESS SINCE 6MONTHS HOPI: PATIENT IS APPARENTLY ASYMPTOMATIC 11 YEARS AGO, THEN DEVELOPED HEADACHE IN THE OCCIPITAL REGION SINCE 11 YEARS WHICH GOT AGGREVATED SINCE 6 MONTHS DURATION - VARIABLE ASSOCIATED WITH NECK PAIN AND ON AND OFF LEFT EAR ACHE NOT ASSOCIATED WITH PHOTOPHOBIA ,NAUSEA , PHONOPHOBIA GIDDINESS SINCE 6 MONTHS WHICH GOT AGGRAVATED SINCE 1 MONTH  - EPISODIC TYPE ,WHICH GETS AGGRAVATED ON SOLEPING AND RELIEVES ...
Read more

28year old female with pyelonephritis

Image
This is an online E log book 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 series of inputs from available global online community of experts with an aim to solve those patient's 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 the comment box  Chief complaints   Fever since 2 days with body pains  Chills since 2 days Right lumbar region pain since 1 day HOPI   Patient Was apparently asymptotic 2days back then she developed chills on Saturday on Saturday night 3.30 am Followed with fever associated with body pains and headache then relieved on medication ( high grade fever) and then Saturday afternoon she had similar complaints with chills and fever then had pain in right lumbar region Pain and fever and relieved on med...
Read more