EXPERIENCES IN CBBLE
My experiences with patients in a case based blended learning ecosystem's CBBLE
June 14,2023
Hello everyone,
This is Koushik Chandra,a medical undergraduate studying in India,I am an apprentice in this wizarding world of medicine and I will try to briefly describe about the different cases and patients I encountered during my postings time in General Medicine department.
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.
So ,let's talk about the first case I encountered,
Case1:
I learned how to take detailed history and correlate it with different symptomatologies with the help of my seniors and PGs.Examinations of different systems were explained and demonstrated by PGs which helped me pass through the difficulties while examining the patient, now let's get to the history of the patient.
A 46 year old male patient came with the complaints of shortness of breath since five days, profuse sweating, generalized weakness and swelling of the lower limbs.
The patient appeared so weak and high grade pitting type of pedal edema was elicited,it was also the first time I saw the process of dialysis and central line catheterisation.
Patient was also a chronic case of diabetes mellitus since 11 years which made us suspect role of hyperglycemia in diabetic nephropathy and also the rise in serum creatine and urea gave a hint about the loss of kidney function, full emphasis on the case is given below
Case2:
Coming to the next case I saw the patient in AMC with high grade intermittent fever associated with chills and rigor since one week and headache which was sudden in onset and throbbing type.
He gave history of vomitings and passing of green stools since 3 days, he gave a history of going to orissa(he is a DCM DRIVER by occupation) where he developed fever,pancytopenia was evident as thrombocytopenia was present along with high grade fever we initially thought it was a dengue case but NS1 ANTIGEN test came negative so we again began enumerating differential diagnosis of the case with the help of PGs.
It was a very informative session as we eliminated different causes to arrive at differential diagnosis of salmonella? Ecoli?malaria? Entamoeba? I am still following up this case to know the exact diagnosis.
https://108koushikchandrarachuri.blogspot.com/2023/06/26-yr-old-male-with-pyrexia.html?m=1
Case3:
The next case I am going to discuss about us Chronic kidney disease.
A 70 yr old female came to OPD with chief complaints of shortness of breath from 10 days ,fever from 10 days,loss of appetite from 6 days ,burning micturition from 4 days,decreased urine output from 4 days.
Patient was taken to hospital 8 days back and diagnosed as typhoid and was treated for the same.
Important point to note here is major risk factors of chronic kidney disease like Diabetes and Hypertension were present from 15 and 10 years respectively and she was taking medicine for it.
Also the patient was obese which will help us get to the theory of adipokines which play a role in developing of chronic kidney disease.Given below is the abstract showing the link between obesity and adipokines.
Given below is the case
https://108koushikchandrarachuri.blogspot.com/2022/09/e-log-medicine_12.html?m=1
During this entire course I learnt how to communicate with patients and tried to understand their way of telling problems and make the diagnosis of the case.
Thank you.
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