Share the link to your own case report of a patient that you connected with and engaged while capturing his her sequential life events before and after the illness and clinical and investigational images along with your discussion of that case.

Ans : https://rishitha35.blogspot.com/2021/07/28-year-old-presenting-with-pain-in.html

Question 3

I have chosen the following case to provide my critical appraisal of the captured data in terms of completeness, correctness and ability to provide useful leads to analyze the diagnostic and therapeutic uncertainties

Renal- https://61tejarshini.blogspot.com/2021/06/general-medicine-case-discussion.html?m=1

1. Hypertensive Nephropathy has been used to describe the clinical syndrome characterised by long-term essential hypertension. HN is the leading cause of ESRD in Africans in the second leading cause of ESRD worldwide

-Two physiological mechanisms have been proposed for the development of hypertensive nephropathy:

i) Glomerular ischaemia- chronic hypertension results in narrowing of pre-glomerulus arteries and arterioles with the consequent reduction in glomerular Blood flow

ii) Glomerular hypertension and glomerular hyper filtration

-Initial hypertension —> glomerular endothelial damage and sclerosis,

subsequently in an attempt to compensate for the loss of renal function the remaining nephrons undergo vasodilation of the preglomerular arterioles and —>increase in renal bloodflow and glomerular filtration.

-The result is glomerular hypertension, glomerular hyperfiltration and progressive glomerulus sclerosis

Most of the patients with hypertension, the condition present for many years as in this case it was present for the past five years because of the periods of accelerated or poorly controlled BP. Hence the patient also witnessed mental status changes which are also the symptoms of Uremia. This caused Uremic Encephalopathy

Above information obtained from: https://www.slideshare.net/RandolphTulsie/hypertensive-nephrosclerosis

2. Uremic Encephalopathy- It’s an organic brain disorder which occurs due to the buildup of toxins which are normally cleared by kidneys.

-It develops in patients with renal failure usually when creatinine clearance levels fall and remain below 15 mL/min.

-Uremia is final stage of progressive renal insufficiency and result in multiorgan failure.

-Results from accumulating metabolites of proteins in amino acids and concomitant failure of renal catabolic, metabolic and endocrinologic processes.

-Uremic encephalopathy is one of many manifestations of Renal failure

- Accumulation of diamethylarginine leads to Vasoconstruction inducing hypertension

Above information obtained from: https://www.slideshare.net/dkatpar/uremic-encephalopathy

Question 4)

DIAGNOSTIC AND THERAPEUTIC INTERVENTION

Diagnostic steps:

1. ECG - report must be taken to check any left ventricular hypertrophy

2. CBC - Detect leucocytosis which may suggest an infectious cause and determine whether anemia is present

3. Urine analysis- MicroAlbuminuria

4. Ultrasound- To check the kidney size whether it’s symmetric or normal or moderately reduced.

5. Order a toxicology screen.

Prognosis:

-Benign Nephrosclerosis:This condition will rarely result in renal failure. As some

renal damage has occurred, patients may be considered to have diminished renal

reserve.

-Malignant nephrosclerosis:This condition will only occur in the context of severe hypertension with diastolic blood pressure in excess of 130mm Hg. Patients will usually have a pre-existing renal disease which has progressed to induce malignant hypertension. At the onset of escalating blood pressure, protein and blood may appear in the urine.

-Haemodialysis Is recommended for patients Who progress to ESKD.

Also referred: https://healthengine.com.au/info/hypertensive-nephropathy

Question 5)

Testing scholarship competency in logging reflective observations on your concrete experiences of this last month :

Since lockdown got us at our homes, i had to spend my majority of first year and now second year too at my home. Being stuck here and not able to have hospital visits really discomforts me.

Being there no patient interaction, i have no such observations or experiences as of now, but am looking forward to these eagerly.

All i can say now is about how covid has affected all of us and that’s the only thing i got to observe and experience lately.

On celebrating as to how we tackled first wave of COVID, the second wave was way too devastating. The economic and social disruption caused by the pandemic is disturbing.

Presently the impacts of COVID-19 in daily life are extensive and have far reaching consequences. Healthcare category got to face a lot consequences too.

- • Challenges in the diagnosis, quarantine and treatment of suspected or confirmed cases
- • High burden of the functioning of the existing medical system
- • Patients with other disease and health problems are getting neglected
- • Overload on doctors and other healthcare professionals, who are at a very high risk
- • Overloading of medical shops
- • Requirement for high protection
- • Disruption of medical supply chain.

Search This Blog

Rishitha Chowdary 35

June Assignment GM

35 Rishitha (3rd sem)

MONTHLY ONLINE ASSIGNMENT

I have been given the following assignment in an attempt to read, comprehend, analyze, reflect upon and discuss captured patient centered data.

Comments

Post a Comment

Popular posts from this blog

GM Assignment July

60 Yr Old Male with Fever.