Internship assesment
G.RAHUL SAI
SCORING:
Mild pancreatitis(0–3 points)
ROLLNO: 52
:MY INTERNSHIP IN THE DEPARTMENT OF GENERAL MEDICINE:
FOR 1ST 15 DAYS I WAS POSTED IN THE DEPARTMENT OF PSYCHIATRY WHERE I GOT THE OPPORTUNITY TO ENCOUNTER INTERESTING CASES...
MOST OF THEM BEING -
ALCOHOL DEPENDENCE SYNDROME
SUBSTANCE ABUSE
DEPRESSION
PARANOID SCHIZOPHRENIA
IMPORTANCE OF HISTORY TAKING...
GOT THE OPPORTUNITY TO VISIT DAC
(DE-ADDICTION CENTER) , HAVE SEEN THE PATIENTS IN DAC , THEIR BEHAVIOUR AND THE DAILY SCHEDULE OF THE PATIENTS
- LEARNT ABOUT AUDIT SCORE WHICH IS PARAMETER IN EVALUATING ALCOHOL DEPENDENCE
0-7: SENSIBLE DRINKING
8-15:HAZARDOUS DRINKING
16-19:HARMFUL DRINKING
>20:ALCOHOL DEPENDENCE
AND FOR THE NEXT 1 MONTH I HAVE BEEN IN
UNIT 4 UNDER
DR.SUSHMITHA MAM( SR )
DR.SASHIKALA MAM ( PGY3 )
DR.SHAILESH SIR( PGY3 )
DR. KEERTHI MAM ( PGY2 )
DR.NAVYA MAM( PGY1 )
OP DUTIES:
DURING MY OP DAYS.. I ENCOUNTERED MANY PATIENTS WITH SEASONAL DISEASES LIKE COMMON COLD , COUGH , DENGUE FEVER , HEADACHES AND COMMON AGE RELATED COMORBIDITES LIKE DIABETES, HYPERTENSION, THYROID DISORDERS.
ON OP DAYS
* I HAVE MONITORED VITALS OF EVERY PATIENTS
* NOTING THE COMPLAINTS OF PATIENTS, AIMING APPROPRIATE QUESTIONS TO THE PATIENT IN THE LIMITED TIME SPAN AND TRIED MAKING DIAGNOSIS
* GOT THE OPPORTUNITY TO LEARN HOW TO APPROACH AND ASSESS THE CASE AND MANAGE THEM
IN PATIENT DUTIES
1)https://52rahulsai.blogspot.com/2023/01/this-is-online-e-log-book-to-discuss.html?m
1Q)What are CT findings in acute pancreatitis?
Typical findings:
-focal or diffuse parenchymal enlargement
-changes in density because of oedema
-indistinct pancreatic margins owing to inflammation
-surrounding retroperitoneal fat stranding
liquefactive necrosis of pancreatic parenchyma:
-lack of parenchymal enhancement (should ideally be 1 week after symptom onset to differentiate from pancreatic hypoenhancement secondary only to oedema)
-often multifocal
infected necrosis:
-difficult to distinguish from aseptic liquefactive necrosis
-the presence of gas is helpful (emphysematous pancreatitis)
FNA helpful
abscess formation:
-circumscribed fluid collection
little or no necrotic tissues (thus distinguishing it from infected necrosis)
haemorrhage:
-high-attenuation fluid in the retroperitoneum or peripancreatic tissues
calcification:
-evidence of background chronic pancreatitis
Criteria and scoring of acute pancreatitis:
Mild pancreatitis(0–3 points)
Moderate pancreatitis (4–6 points)
Severe pancreatitis (7–10 points)
2)http://52rahulsai.blogspot.com/2023/01/65-yr-old-male.html
Q)What is aphasia ? What are the different kinds of aphasia?
-Aphasia involves difficulty producing and/or interpreting language, caused by damage to a specific area of the brain. Aphasia can generally be broken down into the following Types:
Expressive aphasia (also known as Broca’s aphasia): difficulty with spoken and written expression
Anomic aphasia: difficulty with word retrieval, where the person may demonstrate slow, halting speech
Fluent aphasia (also known as receptive aphasia or Wernicke’s aphasia): difficulty producing meaningful sentences. The person generally has no issues with speaking, but the words they say do not make sense. They may also have difficulties with comprehension.
Conduction aphasia: difficulty with repeating words or phrases
Global aphasia: difficulty with speech production, expression, and comprehension
Facial paralysis umn vs lmn:
3)http://52rahulsai.blogspot.com/2023/01/a-75-year-old-male.html
4)http://52rahulsai.blogspot.com/2023/02/25-yr-old-female.html
5)http://52rahulsai.blogspot.com/2023/01/g.html
6)http://52rahulsai.blogspot.com/2023/01/a-60-year-old-female.html
Q)what are the causes of thrombocytopenia?
FOR THE PATIENTS WHO WERE ADMITTED IN MY UNIT I GOT THE OPPORTUNITY TO THE PERFORM DIAGNOSTIC AND THERAPEUTIC ASCITIC TAP IN A CLD PATIENT
LEARNT THE IMPORTANCE OF ASCITIC FLUID ANALYSIS :
ASCITIC FLUID IS SENT TO PATHOLOGY FOR CYTOLOGY,MICRO FOR CULTURE ,BIOCHEM FOR SAAG AND PROTEINS
SAAG CALCULATION:
I HAVE LEARNT THE SKILL OF COLLECTING ABG SAMPLES AND COLLECTED SAMPLES OF 5 to 6 PATIENTS
- ADMINSTERED/ INSERTED FOLEYS CATHETER FOR 4 PATIENTS
- PLACED RYLES TUBE FOR 2 OF MY PATIENTS.
- LEARNT AND COLLECTED IV SAMPLES
- IMPORTANCE OF HEMOGRAM, FEVER CHARTING AND CHANGING TRENDS OF FEVER.
- IMPORTANCE OF 7 POINT PROFILE, AND HOW HBA1C INVESTIGATION CAN HELP TO KNOW THE DIABETIES CONTROL IN PATIENT OF DM
AND FOR THE LAST 15 DAYS OF MY GENERAL MEDICINE INTERNSHIP POSTING I WAS IN PERIPHERALS DUTIES
ICU DUTIES:
- MONITRIED VITALS OF PATIENTS IN ICU EVERY HOURLY AND AMC PATIENTS.
-HAVE TAKEN ABG SAMPLES FOR PATIENTS
-HAVE TAKEN IV SAMPLES AND SENT FOR INVESTIGATIONS
- AND INFORMED MY ICU PGS , IF PATEINT CONDITION IS DETERIORATING
- AND MADE SURE THE PRESCRIBED MEDICATIONS WERE GIVEN IN TIME
- HOURLY GRBS MONITORING FOR A YOUNG FEMALE WITH DM HER GRBS VALUES WENT LOW, AND HOW A 25D INFUSION WOULD MIRACULOUSLY RAISE HER BLOOD GLUCOSE TO NORMAL
- SENT NECESSARY INVESTIGATIONS TIMELY FOR THE ICU AND AMC PATIENTS
NEPHRO DUTIES:
IN MY NEPHRO DUTIES...
-I HAVE ASSISTED IN CENTRAL LINE PROCEDURES
- PERFORMED ASCITIC TAP
- MONITRED VITALS OF DAY CARE DIALYSIS PATIENTS DURING DIALYSIS AND WARD PATIENTS
- AND ADVICED PATIENT TO TAKE ANTIHYPERTENSIVE MEDICATION
- ADMINSTERED IV NTG INFUSION FOR PATIENT WHOSE BP RECORDED HIGH AFTER INFORMING PGS AND CHECKING FOR THE BP TO FALL EVERY 3 MINTUES
HELPED PATIENT ATTENDERS DURING BLOOD TRANSFUSION FROM PAYMENT AND COLLECTING BLOOD TO MONITORING THE PATIENT DURING TRANSFUSION FOR ANY TRANSFUSION REACTIONS.
- GOT TO KNOW , HOW A DIALYSIS MACHINE WORKS
LEARNT ABOUT AV FISTULAS AND HOW ARE THEY HELPFUL FOR PATIENTS WITH CKD
WARD DUTIES;
-MONITERED VITALS FOR WARD PATIENTS
-TOOK IV SAMPLES
-DURING MY WARD DUTIES I HAVE MADE MY CO INTERNS TO PUT SOAP NOTES IN GROUP
- I HAVE DONE PRACTICAL EXAM DUTY
- AND ALLOTED CASES TO THE JUNIORS DURING THEIR PRACTICAL EXAMS AND HAVE TAKEN THE VIDEO OF THEIR CASE PRESENTATION.
I WOULD LIKE TO THANK
DR.RAKESH BISWAS SIR
DR.SUSMITHA MAM
DR.SHASHIKALA MAM
DR.SHAILESH SIR
DR.KEERTHI MAM
DR.KRANTHI SIR
DR.NISHITHA MAM
DR.NAVYA MAM
DR.KIRAN SIR
ALL PGS AND FACULTY OF GM AND ALL MY CO INTERNS FOR EXTENDING THEIR COOPERATION IN MY JOURNEY OF GENERAL MEDICINE POSTING .
