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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
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43year old male came with the chief complaints of Fall due to loss of consciousness

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43year old male came with the  chief complaints of Fall due to loss of consciousness on 4/4/23 Hopi- Patient was apparently asymptomatic till yesterday morning then he had sudden loss of consciousness followed by fall on a cement brick and his clavicle fractured, he had similar complaint in the afternoon. No history of stiffness of both upper and lower limbs up rolling of eye balls , tounge bite . No history of fever, vomiting, neck stiffness, neck pain , and headache .  No history of visual disturbances.  No history of head trauma .  No history of sob , chest pain , palpitations, orthopnea .  Past history  K/c/o DM since 4years and was on medication  K/c/o HTN since 3 years Not a k/c/o asthma , tb , epilepsy and thyroid disorders  Personal h/o  Appetite- normal Diet - mixed Bowel and bladder - regular Any known Allergies- absent Addictions- alcohol- regular 180 ml /day , last intake yesterday morning.  Family h/o - not significant On general examination -  patient is conscious,coheren
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70 year old male came with the chief complaints of chest pain ,cough,sob

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 70 year old male came with the chief complaints of chest pain ,cough,sob since 8-10 days Fever since 1 week Hopi- Patient was apparently asymptomatic 8 days back then he developed cough- Dey,insidious in onset and gradually progressive,diurnal variations present more during night. No seasonal variations. No aggravating or relieving factors. Chest pain left sided non radiating not associated with excessive sweating, palpitations,pedal edema,giddiness Sob since 8 days insidious in onset and gradually progressive,progressed from grade 1 to grade 3 . No orthopnea,no PND No seasonal variation,no diurnal variation. Fever since 1 week ,high grade associated with chills and rigors, Evening rise of temperature present, loss of weight present, loss of appetite present No h/o vomiting,losing stools,pain abdomen. Past h/o-  K/c/o HTN since 2 years K/c/o DM since 6 months Not a k/c/oNot a k/c/o asthma , tb , epilepsy and thyroid disorders  Surgical history - ?patient underwent exploratory laparoto
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48 year old male with shortness of breath, altered sensorium, decreased urine output

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M. Sri Nithya Roll. No-86  Patient came with the complaints of  sob since 1 day,  Decreased urine output since 1 day Altered sensorium since 2 hrs B/l Pedal edema on and off since 1 year Hopi- Patient was apparently asymptomatic 1 yr back then he developed b/l pedal edema , on and off  and was on conservative management. Since then, he was diagnosed with hypertension using tab. Telmisartan 40 mg since 1 year. Since yesterday night patient is having is having sob grade 3 to grade 4,which is sudden in onset and gradually progressive, associated with PND, not associated with chest pain or sweating. No c/o fever, vomitings or loose motions . Past history - Not a k/c/o DM, tb , asthma , epilepsy, thyroid disorders, cad or CVD. History of alcohol and smoking present since 25 years Family History There is no significant family history On examination- There is no pallor, icterus, cyanosis, clubbing, lymphadenopathy B/l pedal edema present, pitting type extending up to the knee Temp- 98. 6F PR-
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80 years old male came with the complaints of shortness of breath since 15 days

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 M. Sri Nithya  Roll. No 86 Patient came with the complaints of shortness of breath since 15 days B/ l pedal edema  and facial puffiness since 3 days Burning micturition and decreased urine output since 2 days Patient was apparently asymptomatic  5 months ago then he developed shortness of breath and visited local doctor and took treatment and then it subsided. Now patient presented with shortness of breath since 15 days, insidious in onset and gradually progressive from grade 1 to grade 3. Orthopnea present, no PND No h/o chest pain, palpitations , excessive sweating, giddiness, vomiting. B/l pedal edema,pitting type, extending up to the knee joint present and facial puffiness present since 3 days Burning micturition and decreased urine output since 2 days No h/o fever, cough, cold, vomitings or loose motions K/c/ o type 2 diabetes mellitus since 6 years on tablet metformin 500 mg po/od K/c/o HTN since 8 years on tablet metoprolol 0.25 mg po/od H/o CVA 8 years ago ?TIA took medication
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