INTERNSHIP ASSESSMENT

 NAME: J. AKASH 

R. NO -53

ADM NO:176208

I HAVE BEEN POSTED IN GENERAL MEDICINE FROM  12/12/2022 TO 11/02/2023

IN THIS BLOG I'M SHARING MY INTERSHIP WORKING EXPERIENCE 



PSYCHIATRY DUTIES


FIRST 15 DAYS  12/12/2022 TO 26/12/2022  I HAVE BEEN POSTED HERE

MY LEARNING POINTS IN PSYCHIATRY POSTING:


LEART HOW TO TAKE HISTORY FOR PSYCHIATRY PATIENTS 

CASES I HAVE SEEN ARE 

1.ALCOHOL DEPENDENCE SYNDROME

2.ADJUSTMENT DISORDERS

3..TOBACCO DEPENDENCE SYNDROME 

4.SCHIZOPHRENIA

5. OBSESSIVE COMPULSION DISORDER



learnt how to manage patients in de-addiction centre


checking vitals for patients in op

Monitored a case of 55year old male patient with alcohol dependence syndrome.

 assisted in the management of this patient with the help of Dr nirupama and Dr spandana




UNIT DUTIES FROM 27/12/2022 TO 26/01/2023

i was posted in unit for 1month and my pgs were Dr Himaja ,Dr Deepika, Dr Vinay sir for first 1week

For remaining days my pgs were Dr Himaja , Dr pavani, Dr Sai charan sir


On OP days 

Vitals monitoring of op patients

learnt how to take history briefly for patients cane to op

learnt prescription writing for op patients and need for each medicine prescribed 

leant how to evaluate patient clinical based on history

leant how examine patient clinically

leant how to approach a case based on on clinical history  on op day night  in casualty

learnt IV cannula insertion,did approximately for  8-10 patients

learnt Ryles tube insertion for 3 patients

learnt how to put foleys catheter and for 6 patients

drew ABGs for patients with shortness of breathe


case-1 

https://www.blogger.com/u/1/blog/post/edit/9056498176038528263/9157823971983697141

This is a case 60 year old male with altered sensorium secondery to hyponatremia  with small hemorrhagic contision of frontal lobe with AKI resolved with HTN since 4years with Diabetes type-2 with 18years

my learning points in this case;

I learnt how to approach a case of altered sensorium

and how manage case of electrolytes imbalance 

learnt how to elicit reflexes and sensory examination.



case-2

 https://akash688.blogspot.com/2022/12/j.html

 This is a Case of 50 year old male came with c/o abdominal distension and decreased apetite and significant weight loss diagnosed as Moderate Ascitis (Low SAAG high protein) with TB peritonitis


My learning points in this case

  I learnt ascitic tap and did with the guidance of Dr Pavani mam , i did under sterile condition followed Z technique 

PROCEDURE:  ASCITIC TAP

    



How to approach a case of fluid distended abdomen



Case-3

https://www.blogger.com/u/1/blog/post/edit/9056498176038528263/3771460075064821182

This is a case of  60year old female came with c/o fever, decreased apetite, difficulty in micturition for 4days and diagnosed as pyrexia secondary to UTI with hyponatremia and hypokalemia 

with H/o post laminnectomy 

my learning points for this case;

i did put foleys catheter for female patient for the 1st time for this case with consent

Examination of  central nervous system


Case-4

https://www.blogger.com/u/1/blog/post/edit/9056498176038528263/1075159133552959085

  This is a case of  33year old male with fever with thrombocytopenia with AKI with acute liver injury managed conservatively.

my workup and learning points:

Learnt approach of case with deranged LFT 

skin yellowish discoloration present over face,chest, abdomen,arms,palms&soles





Case-5

https://www.blogger.com/u/1/blog/post/edit/9056498176038528263/4494129660260804367

case of 20year old female with libmann sachs endocarditis with H/o Cardioembolic stroke




case-6

https://www.blogger.com/u/1/blog/post/edit/9056498176038528263/4987234829638805406

This is a case of 55year old male superficial burns over face due to oil spillage over face admitted to GENERAL SURGERY department , investigations were done and found to have elevated pancreatic enxymes and c/o mild abdominal pain Diagnosed as Acute pancreatitis  (with 3-5% Superficial facial burns grade 1-2 )


Case-7

https://www.blogger.com/u/1/blog/post/edit/9056498176038528263/6966459895347464834

This is a case of 60 year old male c/o loss of speech for 1day H/o pulm Kochs ,on ATT and stopped , necessary investigations were done On MRI-SubAcute infarct in corona radiata , Urine culture -positive E.coli isolated Diagnosed as Septic encephalopathy secondary to urosepsis k/c/o pulm Kochs with ATT induced hepatitis, Anaemia of chronic inflammation.

my learning points for This case:

ATT therapy: Daily and intermittent ATT therapy 

Adverse drug reactions eg hepatitis due to use of ATT drugs

Dose & combinations of ATT drugs



PERIPHERALS FROM 27/01/2023 TO 11/02/2023

WARD DUTIES:

attended rounds

updated soap notes of ward patients

exam duty for u dergraduate students


ICU DUTIES;

vitals monitoring for patients

Drew ABG for patients


NEPHROLOGY DUTIES:

Vitals monitoring for patients on hemodialysis

assisted CPR for a patient with cardiac arrest with the help of Dr kranthi

drew samples for few patients

learns managemnet of elevated BP during dialysis.











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