INTERNSHIP ASSESSMENT

UNIT DUTY:-
(1) 36 yr old female with fever
http://vishaladhani148.blogspot.com/2022/09/36-yr-old-female-with-fever.html

(A) What are the warning signs & evidence which proves that she has severe dengue? 
(a) warning signs include- Abdominal pain  & persistent vomiting. 
   Severe dengue include- elevated liver enzymes &raised PCV. 

(B) what could be the reason for her elevated liver enzymes? 
(a) 
People also askWhy do liver enzymes increase in dengue?
 Hepatocyte apoptosis directly by the virus, hypoxic damage due to impaired liver perfusion resulting from fluid leakage, oxidative stress or immune mediated injury . 
(C) What  are the evidences to say that she landed up in ARDS? 
(a) clinically she developed shortness of breath. Her saturation also reduced. 
Xray showing B/l pleural effusion. 
Pao2/fio2 ratio- 252 MILD ARDS


(2) 70 yr old female with SOB? 
http://vishaladhani148.blogspot.com/2022/09/70yr-old-female-with-sob.html

(A) why her troponin levels are elevated? 
(a) It could be because of sepsis

(B) I have assisted in intubation and i learnt how to put patient on ventilation. How to set mode of ventilation, peep, tidal volume according to weight of the patient. 

3) 25 year old male with recurrent fever spikes 
    A) what could be the cause for his pancytopenia? 
   a) Due to vit B12 deficiency. 
  B) Treatment given was? 
    a) INJ Methylcobalmin 1500 mcg for 1 year
    C) what could be the cause for his vit B 12 deficiency? 
    a) mostly due to nutritional deficiency. 

4) 13 YEAR Female with anemia 
A) what could be the reason for her iron deficiency anemia? 
  a) mostly nutritional deficiency 
B) I have assisted in blood transfusion for her 

C) what is the indication for her blood transfusion? 
 a) she landed in heart failure (high output failure) clinically she has raised jvp
D) I learnt the complicatioms associated with blood transfusion. 

NEPHRO DUTY
1) A 52 yr old male with CKD ON MHD
  A) I have taken the blood samples and send it for investigatioms
B)  I have assisted him during dialysis

2) A 65 Year old female with uremic encepahlopathy and left upper limb cellulitis
   A) I have assisted during central line
  B) I have assisted during dialysis

3) I have taken the blood samples of all patients in ckd ward 

4) A 55 year old male with ckd on mhd
   a) I have assisted him during dialysis


ICU DUTY

1) (A) I have taken the ABG samples of all ICU patients
    (B) I have taken the blood samples for investigations 
    (C) I have given IV INJECTIONS for all ICU patients 
    
(2) A 80 year old male with encepahalopathy secondary to respiratory failure
   A) I have assisted  during intubation
   B) I have put ryles tube for him

3) A 19 year old female with Pancytopenia
    A) I have assisted during intubation

4) A 47 year old female with abdominal distension
  A) I have assisted her in asictic tap
    
 
During Psychiatry postings:
(1)I have learnt how to take history taking
(2)I have learnt Different ways on how to counsel the patient 
(3)Seen cases of Alcohol dependence, schizophrenia,obsessive compulsive disorders, depression.
(4) Attended DAC rounds .
(5) I have learnt how the medication are prescribed for cases of alcohol dependence.





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