My experiences with general cellular and neural cellular pathology in a case based blended learning ecosystem's CBBLE

 Hello,

This is CHOPDE AKHIL ,
 A medical undergraduate studying in India.
I would like to share some of the interesting cases that helped me to learn and build my knowledge in the field of medicine.
I'd also like to thank my seniors and my professors for guiding, teaching and enhancing my knowledge in the field of medicine and also in making me better as a person.

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.


After learning the basics of human body in first year of my MBBS through the subjects like Biochemistry , Anatomy and Physiology , clinical exposure started from second year .

My first encounter with a patient :

BLOG - 1

 A 59 year old male patient came with chief complaints of pedal oedema and shortness of breath since 3 months .
Patient had developed B/L pedal edema which is pitting type which is aggravated towards end of the day and subsides in morning  and had Shortness of breath - Grade 2 for which he went to private hospital in Suryapet and used medication prescribed by them but he was not satisfied so he went to NIMS in Hyderabad 15 days ago for which they diagnosed him with chronic renal failure and done 2 rounds of heamodialysis ,  then the patient came to us for follow up because our hospital is near to his house , now he is undergoing heamodialysis in our hospital . He also has Periorbital puffiness


After investing his past history , i came to know that patient had undergone Coronary artery bypass surgery 12yrs ago and subsequently also developed DM2 and HTN.


 Later i asked about his lifestyle , his habits and addictions . His diet was mixed , bladder movement were normal but his sleep was disturbed . He had no addictions as well .

When asked about his daily routine i came to know some facts like :
Patient is shop vendor by occupation, he wakes up by 7 to 7:30am in morning and does his personal activities and has breakfast at 9am and goes to his shop and comes to home for lunch at 1 Pm and after having lunch sleeps upto 3.30 pm and wakes up and goes to shop and returns to home for dinner around 8 pm and then he watches Tv and do conversations with neighbours upto 10 pm then he goes to sleep.

Later i conducted general examination of the patient and further investigation were done accordingly 



BLOG - 2


A 65 year old female who came with chief complaints of loose stools was brought to casuality early  in the morning with complaints of loose stools since 5 days and pain as  as she was screaming and restless with altered 

She passed loose stools- watery in consistency, foul smelling and blood tinged 4-5 episodes / day . She apparently consumed kaya churnam (an ayurvedic powder) , went to RMP nearby and was given medication,  even then loose stools did not stop .apparently after eating curd rice ,  when patient slept , suddenly in the middle of night patient was screaming due to pain  and could not talk anything. She was then bought to casuality.

Apparently, a few yrs back , she slipped and fell  in bathroom and  was in a confused state for 10 to 15 days and during that period couldnt recognize anyone and couldnt talk and later when she was conscious, she could recognize their family members and diagnosed with hypertension. But since then, she restricted herself to bed and didnt walk much due to fear of falling down and didnt do much work.

 She is going for regular checkups  once in every 3 months for BP and weakness.

https://www.blogger.com/blog/post/edit/5681763852578743549/4297054425827611207


BLOG - 3


A 34 year old male patient , lorry driver by occupation came to OPD with chief complaints of Vomiting .
Vomiting is present immediately after food,water and alcohol intake.After vomiting he was associated with generalized weakness for which he went to local hospital and was under normal saline 3 days back.
There is history of dark stools 3 days back lasted for 1 day, which is non blood stained.
Hiccups Since 3 days continuously and associated with mild difficulty in swallowing 
Cough- dry since 3 days not associated with fever sore throat cold.
Similar complaints --3 months back he had vomiting and was diagnosed with jaundice

https://www.blogger.com/blog/post/edit/5681763852578743549/3441322017085705868

BBB

BLOGFinallyc, I mentioned conducting a general examination and noted that the patient appeared conscious, coherent, and cooperative. I asked the patient to confirm if they had any pallor, icterus, cyanosis, clubbing of fingers, or swollen lymph nodes. The patient confirmed having some pallor but denied the presence of icterus, cyanosis, clubbing, or swollen lymph nodes.


After further questioning about his general well being I examined the patient for any further ailments he could possibly have .


 lifestyle, including their diet and any specific eating habitsMoving on, I asked for information about the patient's lifestyle, including their diet and any specific eating habits. The patient mentioned having a mixed diet with a normal appetite but noted that their bowel movements had changed over the past two days.


I expressed gratitude for the information provided and proceeded to ask about habits or addictions, such as smoking, tobacco use, or alcohol consumption. The patient disclosed consuming about 90 ml of alcohol 2-3 times a week for the past 20 years.. The patient mentioned having a mixed diet with a normal appetite but noted that their bowel movements had changed over the past two days.


I expressed gratitude for the information provided and proceeded to ask about habits or addictions, such as smoking, tobacco use, or alcohol consumption. The patient disclosed consuming about 90 ml of alcohol 2-3 times a week for the past 20 years.on, I asked for information about the patient's lifestyle, including their diet and any specific eating habits. The patient mentioned having a mixed diet with a normal appetite but noted that their bowel movements had changed over the past two days.


I expressed gratitude for the information provided and proceeded to ask about habits or addictions, such as smoking, tobacco use, or alcohol consumption. The patient disclosed consuming about 90 ml of alcohol 2-3 times a week for the past 20 years





 








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