INTERSHIP ASSESSMENT
Name :P MURALI KRISHNA
DURING ICU DUTY
CPR for 48 year old male
Assisted in Intubation
Monitored vitals of the patient.
Took ABG samples
Inserted Foleys catherter
DURING NEPHROLOGY
Assisted in central line under the guidance of DR. Bharath
Monitored vitals of patients during dialysis
DURING WARD DUTY
Collected venous samples for routine investigations
Updated soap notes
DURING UNIT DUTY
CASE 1
My orientation around this case:
1 Thrombocytopenia in dengue
* Different mechanisms have been hypothesized to explain DENV-associated thrombocytopenia
* suppression of bone marrow and the peripheral destruction of platelets. Studies have shown DENV-infected hematopoietic progenitors or bone marrow stromal cells. Moreover, anti-platelet antibodies would be involved in peripheral platelet destruction as platelets interact with endothelial cells, immune cells, and/or DENV.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4427128/
2 Pathophysiology in dengue shock syndrome
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3097561/
CASE 2
2)http://muralikrishna98.blogspot.com/2022/10/18-years-old-patient-came-to-opd-with.html
My orientation around this case:
1 Causes of anaemia in females
*Chemotherapy or other medications affecting the bone marrow cells responsible for making red blood cells.
*Iron deficiency.
*Lack of vitamins needed for red blood cells.
*Low levels of erythropoietin
*Chronic inflammation.
*Bone marrow disorders.
https://www.google.com/amp/s/www.cohamed.com/blog/anemia-in-elderly-females
2 IRON CYCLE
CASE 3
3)http://muralikrishna98.blogspot.com/2022/11/75-year-old-female-patient-was-brought.html
My orientation around this case:
1 What drugs used in heart failure
*Drugs to help relieve symptoms: Diuretics, vasodilators, or digoxin
*Drugs to help improve survival: Angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, aldosterone antagonists, angiotensin II receptor blockers (ARBs), angiotensin receptor/neprilysin inhibitors (ARNIs), sodium-glucose cotransporter-2 inhibitors (SGLT2s), or sinus node inhibitors
https://www.msdmanuals.com/en-in/home/heart-and-blood-vessel-disorders/heart-failure/drug-treatment-for-heart-failure use
Framingham Criteria for the Diagnosis of
Heart Failure
Major criteria:-
*Paroxysmal nocturnal dyspnea, or orthopnea
*Jugular venous distension
*Cardiomegaly
*Acute pulmonary edema
*Third heart sound gallop Central venous pressure >16 mm Hg
*Circulation time>25 s
*Hepatojugular reflux
Minor criteria:-
*Ankle edema
*Night cough
*Exertion dyspnea
*Hepatomegaly
*Pleural effusion
* One-third reduction in vital capacity in relation to the maximumn
*Tachycardia (>120 beats/min)
*Weight loss >4.5 kg in 5 days in response to treatment
Two main criteria or one main and two minor are required. Other possible causes should be discarded from the minor criteria.
