MY EXPERIENCES WITH GENERAL CELLULAR AND NEURAL CELLULAR PATHOLOGY IN A CASE BASED BLENDED LEARNING ECOSYSTEM'S CBBLE

MAY 30TH 2023

This is Sai Charishma ,a medical student from India. As a student in the general medicine department, I embarked on a transformative journey, witnessing challenges and complexities of patient care. In this platform, I will share the glimpse into my journey in the department and recount my experiences and invaluable lessons I gained during my time in the department.

CBBLE PAJR PARTICIPATORY LEARNING ACTION RESEARCH DISCLAIMER

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

My first interaction with a patient in the medicine dept was in 2022, I was walking past the nephrology ward where I saw an old lady waiting for her round of dialysis, I went up to her and asked her what made her come to the hospital. She went on explaining that she had been experiencing shortness of breath from a couple of months and I noticed there was generalized swelling of body , it intrigued me and upon asking further history I got to know that she was known case of diabetes mellitus and hypertension. Then I couldn't help but reviewed her reports and there was elevated creatinine and urea levels.

The elevated creatinine and urea levels indicated there was kidney dysfunction which was the reason for the accumulation of such toxins and that explains the symptoms pedal edema and decreased urine output.

https://jogamsaicharishma60.blogspot.com/2022/08/a-70-year-old-female-with-ckd.html?m=1

 As I finished learning about my first patient in my life, there were myriad of emotions filled in me and couldn't help but feel the responsibility to treat the patient at my level best.

A 66YR OLD WITH MULTIPLE PAINFUL BLISTERS

I encountered this patient during my clinical rotation, the 66 yr old male shepherd came to OPD with the complaints of blisters all over the body associated with itching since 5years and there was swelling  of the distal part of left middle finger filled with serosanguinous fluid. Upon taking further history  I got to know that the patient was known case of diabetes mellitus and hypertension since 5 years. During this I got to see the procedure of incision and drainage which was done by the resident in the dermatology department.

As a third year undergraduate, I had limited knowledge on dermatology but with the help of my seniors I understood how they came to the diagnosis of bullous impetigo and folliculitis with acute paronychia.

https://jogamsaicharishma60.blogspot.com/2022/08/a-66-year-old-male-with-multiple.html?m=1

This case made me look into the other common dermatological diseases and learn about them.

A 27 YEAR OLD MALE WITH YELLOWISH DISCOLORATION OF EYES

I came across this patient recently during my clinical rotation, this is a case of 27 yr old male  who came to OPD with yellowish discoloration of eyes since 2 years, generalized weakness and loss of appetite since 20 days. On taking further history, I got to know that he was an alcoholic from the age of 21. On examination, he showed typical symptoms of chronic liver disease i.e, pedal edema (pitting type), facial puffiness, parotid swelling, hair loss, leuconychia, darkly stained stools, constipation, fever, flappy tremors,  shifting dullness indicating ascites and splenomegaly.

https://jogamsaicharishma60.blogspot.com/2023/04/a-27-year-old-male-with-generalised.html?m=1

A 35 YEAR OLD FEMALE WITH GENERALISED WEAKNESS

This is a case of 35 year old female who came to OPD for the further treatment of her condition as she was already diagnosed as anemic, with the help of my residents we diagnosed that the anemia was secondary to menorrhagia by taking detailed menstrual history.

https://jogamsaicharishma60.blogspot.com/2023/04/a-35-year-old-female-with-fever-and.html?m=1

A 14 YEAR OLD FEMALE WITH SOB AND HEADACHE

This was my most recent case that I encountered in my clinical rotation. A 14 year old female known case of type 2 diabetes mellitus came to OPD with complaints of shortness of breath and vomitings. On taking further history we got to know that she missed her insulin injections and after that she developed the above symptoms. This was a typical diabetic ketoacidosis case and patient's condition improved  after providing appropriate treatment by giving electrolytes and insulin. 

https://jogamsaicharishma60.blogspot.com/2023/04/a-14year-old-female-with-shortness-of.html?m=1

This case gave me the valuable insight of importance of treatment of such acute conditions in simple ways and if such immediate care is not provided for such conditions it can lead to threatening complications. It also made me think that it's the doctors responsibility to create the awareness of danger signs of such morbid conditions.

CONCLUSION

• Working the general medicine department gave me opportunity to forge relationship with my patients, these interactions taught me the significance of communication between in a doctor and patient.
• The valuable time in the department also made me realise the vital role of research in advancing medical knowledge and improving patient outcomes.
• This time gave me a profound understanding and responsibility that comes with being a healthcare provider.

THANKYOU