INTERNSHIP ASSESSMENT



This blog is my learning experience in medicine posting, which was from 12 February 2023 to 13 April 2023.

M. Sri Nithya
Roll. No -86

My medicine posting during the internship was started on 12th February , Sunday.  I was posted under unit 2, under SR.DR. ABHINAYA, and PGS- DR.VINAY, DR PRADEEP , DR.DEEPIKA, DR.PRACHETHAN, DR.AJAY KUMAR, DR. HARIKA.

 Since it was my starting day I came for the rounds and came to know about the current status of my patients

My unit duty day was on Tuesdays, so in the OP I learned history taking , clinical examination and with the help of our pgs I also learned interpretation of x-rays and ecgs. I also  learned  what are the investigations should be sent to rule out differential diagnosis and also treatment regimen that should be given for certain diseases. 

We used to get minimum OP of 80-110 , and I tried to take history of atleast 50-60 patients. It was so interesting for me to see the patients coming with different symptoms for same disease and some times even no symptom.

I learned CNS, CVS, and RESPIRATORY SYSTEM examinations and I also have saved them in my blogs so that they might help me in future.

During the duty days we also looked after the casualty cases which are emergencies and I have also got the opportunity to do CPR for two cardiac arrest patients during my casualty duties but unfortunately they did not survivešŸ˜¢. It was sad but challenging and I would never give up. 

Under my PGs guidance I got the opportunities to perform pleural tap and ascitic tap.

During my casualty duties I really got lot of opportunities to perform NG tube placement, foleys catheterization, drawing samples, putting iv cannulas, drawing ABG samples and also learned to interpret ABGs.

Here are some of the interesting cases that I have seen during my internship postings-


https://srinithya27.blogspot.com/2023/04/43year-old-male-came-with-chief.html


https://srinithya27.blogspot.com/2023/03/70-year-old-male-came-with-chief.html


https://srinithya27.blogspot.com/2023/03/48-year-old-male-with-shortness-of.html


https://srinithya27.blogspot.com/2023/02/sri-nithya-roll.html


https://srinithya27.blogspot.com/2023/02/70-year-old-female-with-complaints-of.html


https://srinithya27.blogspot.com/2023/02/65-year-old-female-with-complaints-of.html


https://srinithya27.blogspot.com/2023/02/20-year-old-male-with-fever-since-6.html


https://srinithya27.blogspot.com/2023/02/18-year-old-female-came-to-casuality-on.html


https://srinithya27.blogspot.com/2023/02/70yr-old-male-with-altered-sensorium.html


https://srinithya27.blogspot.com/2023/02/65-year-old-female-with-community.html


PERIPHERAL POSTINGS-

ICU -

I started my peripheral postings with ICU . These are the most loved duties of mine which really made me much interested in medicine. During my ICU duties I worked under DR. NISHITHA ma'am. With the help of her I learned so much during my duties.My ICU duties helped me to learn monitoring the patients which are so vital in improving their outcome.

On my first ICU duty day two patients went to cardiac arrest one in the morning for which I have done CPR  to the patient, it was successful and then the patient was intubated and I have monitored the patient till his discharge and I am also following his health status after the discharge through PaJR group. So I got the opportunity to learn about the patient's condition, the reason for which he was landed and the treatment that has to be given .

On the other side the patient with almost similar condition like the first one went in to cardiac arrest in the evening but we couldn't save him although we tried our best. So I realised that there will be different outcomes for different patients and there are many things that should be learnt in every patient.

And I also came to know why the vitals are really vital for a patient. I learned to monitor the patient with unstable blood pressures on ionotropes and many patients with high blood sugar levels with grbs monitoring and insulin injections.

I also got the opportunity to monitor the ventilator patients. I came to know about  CPAP,BiPAP,its working, use and also the patient compliance with it. I felt it was really a great task for me to maintain their complaince with it. 

Overall i learned about the course of the patient in hospital, their outcome and prognosis in ICU duties.


NEPHROLOGY -

After the completion of my ICU duties then I went for my nephrology duties where there I worked under DR. PAVAN KUMAR. 

In nephrology duties I saw many patients coming for dialysis on shifts per day which really was unexpected for me. Their shooting blood pressure levels surprised me. During dialysis I got the opportunity to make AV FISTULAS, learned about dialysis machine working , advantages and side effects of dialysis.

I also got the opportunity to learn from Dr. PAVAN KUMAR sir in performing CENTRAL LINE. 



WARD ROTATIONS 

 It is one of my favourite times.  During my time there, I was able to see different cases in the ICU/AMC/Ward that were taken care of my unit and also other units and was able to take my own history for some patients. 

Ward rotations gave me the opportunity to follow up and be in constant touch with my patients with the help of PAJR groups.




WARD ROTATIONS 

Ward postings were one of my favourite time in postings, because during rounds I was able to see different cases in the ICU/AMC/Ward that were taken care of my unit and other units and was able to take my own history for some patients. 

Ward rotations gave me the opportunity to follow up and be in constant touch with my patients with the help of PAJR groups.



PSYCHIATRY POSTINGS 

I was posted in the department of psychiatry for 15 days.

Psychiatry is a subject that I’m very interested in. The mental health is what many people ignore that might lead to disturbance in physical health. 

Some cases I saw included schizophrenia, panic attacks, depression, bipolar disorder, substance abuse .

I learned history taking from the pgs, learned about many psychiatric illnesses, the questionnaire for a particular psychiatric illness, interpretation, classification and treatment.

I have seen many patients with substance abuse disorder and many of them joining de-addiction centre.  I also have attended few classes given for patients in the deaddiction centre like meditation classes, music therapy, counselling sessions. 

And also liked the way to handle the patients with unstable mental health which requires lots of patience and understanding people's mind and counselling them. 


Overall, the general medicine posting was a great learning experience, and taught me important clinical and social skills that will hopefully help be better evaluate and treat patients in the future. 


Comments

Post a Comment

Popular posts from this blog

70yr old male with altered sensorium secondary to ?Meningitis

Image
  Sri Nithya Roll.no-86 ICU-BED. NO -03 A 70 Years Old Man Who was a Farmer By Occupation Presented to Casualty With  Altered Sensorium Since 3 Days  Fever Since 20 Days  HOPI :  Patient Was Apparently Asymptomatic Till 2014 ; 2014 - Patient Had Fever Associated with Cough for which he went to Hospital & Was Diagnosed to Have ? Pneumonia with DENOVO DM2 & Was Prescribed with OHAs ( Tab.METFORMIN & Tab.GLIMIPRIDE ) 6 Months Back - Patient Had Fever Associated with Cough for Which he Went to Hospital & Said to Have High Sugars along with Lung Infection ; Got Treated & Discharged in a Hemodynamically Stable Manner.Started using insulin for Diabetes Since Then  20 Days Back : Patient Had Fever with Cough ; For Which He went to Hospital & Suspected to Have TB But Reports Turned out to be Negative & Patient Discharged as LAMA & When He Returned Home 3 Days Back He Gradually Developed Altered Sensorium & Couldn't Recognise His Attendants Past History :
Read more
Image
  CASE-1 1) Pulmonology (10 Marks)    A) Link to patient details:     https://soumyanadella128eloggm.blogspot.com/2021/05/a-55-year-old-female-with-shortness-of.html   Questions:   1) What is the evolution of the symptomatology in this patient in terms of an event timeline and where is the anatomical localization for the problem and what is the primary etiology of the patient's problem?   2) What are mechanism of action, indication and efficacy over placebo of each of the pharmacological and non pharmacological interventions used for this patient?   3) What could be the causes for her current acute exacerbation?     4. Could the ATT have affected her symptoms? If so how?     5.What could be the causes for her electrolyte imbalance?   1)EVOLUTION OF EVENTS OF SYMPTOMATOLOGY    1)shortness of breath which is on and off since 20 years.     2)pedal  edema since 15 days up to the level of the ankle, pitting type. 3)facial puffiness since 1
Read more

65 year old female with complaints of involuntary movements of left upper limb since 1 day, cough since 4 days

Image
 M. Sri Nithya Roll. No -86 Unit-2 Chief compliants A 65 yr old female patient came to casualty with complaints of involuntary movements of Lt upper limb since 1 day  Cough since 4 days  HOPI  Pt was apparently asymptomatic 1 week ago then she developed generalised weakness , fell down from bed and complaints of pain in the hip  Involuntary movements of lt upper limb since 1 day to and fro  No history of speech abnormalities , weakness in the upper limb and lower limb . No H/o memory loss and abnormal posturing . Complaints of cough since 4 days ,it is productive scanty sputum - white to yellow ,non blood stained and non foul smelling  H/o inadequate controls of sugars from 4 months  N/H/o vomiting ,sob,loose stools ,pain abdomen K/c/o type 2 DM since 30 yrs on infusion since 10 yrs  ( Insulin - lispro 20-x-20 ) K/c/o HTN from 20 yrs on T prolomet - xl 50 mg  T. Atenolol 25 mg po/ od at 10 am K/c/o hypothyroidism from 15 yrs on thyronorm 75 mcg Previous treatment history Hospitalised 1
Read more