Intern online assessment

Intern online assessment -General medicine

2nd Oct,2022


A.Bhavani

Unit-1

Rool.no-07

2017batch


Unit-1month

Psychiatry-15days

Peripherals-ICU,nephrology,Ward-15days


During unit duties


I was posted under unit 1 under SR.DR.Zain and PGS- DR.DurgaKrishna, Dr.Pradeep kumar DR.Pavan ,Dr.Keerthi


Unit duties mainly consist of OP days, along with looking after casualty cases and overall monitoring and treatment regimens of the patients that get admitted under your care. 


These are the blog links of some interesting cases that I saw which were admitted during my time in unit-1

Case1

https://bhavani150.blogspot.com/2022/09/general-medicine-elog.html

Learning points

1)What are the cardiogenic and pulmonary causes of SOB?

2)LRTI causes,prognosis 


Case2

https://bhavani150.blogspot.com/2022/09/58year-old-male-patient.html

1)How to differentiate peripheral neuropathy due to Diabetes mellitus and Chronic alcoholism

2)How can we assess the prognosis of Diabetes mellitus and how to prevent the complications



Case3

https://bhavani150.blogspot.com/2022/09/amc-20-year-old-female.html


Case4

https://bhavani150.blogspot.com/2022/09/amc-24-year-old-female.html


Unit duty was a great opportunity to be able to learn how to handle a multitude of patients and about treatment and evaluation of different cases.

Our OP days are on Mondays , and we see around 70 to 1110 cases per day. We had a great opportunity to take history from the patients and evaluate them and come to a diagnosis with the help of PGs and SR. I got to know what are the specific history to be asked to a particular case and the importance of history taking in diagnosing the case. As there would be lots of patients waiting,OP days are great opportunity where we learn how to assess the patients in short time efficiently.I also learnt what are the real essential diagnostic test required for a particular case to diagnose it.. instead of sending some random routine investigations. I had a great opportunity to do clical examination of patients which plays a very vital role in diagnosis.

I got to know how to interpret different ECGs, 2D ECHO’s, X-rays which help us in evaluating each case.

After the investigations , here comes the ultimate part for which patient comes to the hospital to get relief from their I'll health,that is treatment ..In the OP days I had opportunity to learn what is the. treatment given for each case 

Sometimes patients used to come with different problems related to DVL , orthopedics, Surgery.... not only related to General medicine, During the OP days , I had opportunity to evaluate the patient and what is the reason for the problem and take them to the concerned department for examination and treatment.Here I got to know the importance of multi system approach and it's importance in treatment of patients.

I realised,Treating the patient just once is not enough , because some of our patients come to the OPD with the same complains again and again or sometimes the problem may even worsen then I understood the importance of follow up of patients. So we created pajr groups for the OP patients , which is a great initiative by our HOD sir



ICU and AMC duties



Worked in ICU and AMC for 5 days under Dr.Nishitha

Normally even during the other duties I used to go and attend rounds in ICU and got the cases .But only during the 5 days of posting in ICU I got to the importance of ICU and the care the patients here need. I got to know how to differentiate between seriousness of cases and which cases to be shifted to ICU and AMC and which ones to ward.

It was a great learning experience where , I we get both knowledge and gain clinical skills which are really essential.

I got opportunity to draw many blood samples and the vacutainers which are used . I got opportunity to draw ABG samples , intially PG helped me in drawing ABG samples,later I got opportunity to draw around 20 to 25 samples during those 5 days.

I got opportunity to learn, how to place and Remove ryles tube and placed ryles tube to 2 patients . Observed what are the feeds given and the timings of the feeds through NG tube.

Got opportunity to learn life saving skill CPR and Done CPR for 3 patients in ICU who went into cardiac arrest.

Got opportunity Insert foleys to 6 patients 

Assisted in placing Central line for 2 patients  

Done 2 ascitic taps under the guidance of PG





NEPHROLOGY DUTY

I have done nephrology duties under the guidance of Dr.Narsimha and DR.Manasa

Got opportunity to learn and closely observe the dialysis unit. Got to know the importance of dialysis and the need to monitor the patients undergoing dialysis. 

Importance of AV fistulas

Seen cases which worsen during the dialysis 





WARD DUTIES

I worked under DR.Nishitha

During unit duty I used to take care of only unit patients even if I know what are all the cases present. Ward duty is a great opportunity to learn about all the patients. 

I got to know about different types of cases in the ward. Collected the detailed history of patients. Here I realised the importance of history taking in diagnosing and treating the patient.

Created paJr groups for following the patients even after the got discharged.




PSYCHIATRY POSTINGS

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

During my UG days when I attended postings I used to think that Psychiatry is very fascinating ..as the history of the patients is very interesting and each patient has a different story and history.

But during the internship I realised the depth of the subject. Got to see many cases of Schizophrenia.,but each of them have different approach of diagnosis and treatment.

Saw cases of Depression, Generalized anxiety disorder, Panic attacks, Bipolar disorder, Delirium, Substance abuse, Alcohol dependency 

Used to go to de addiction ward and saw what are the activities they make the patients do and their treatment.

Monitored patients in ward with delirium 

But what I observed is even now Many patients donot approach psychiatrist due to lack of awareness and social stigma. Patients What we see in OPD are just tip of the iceberg...many patients who are really in need of psychiatrists needs to get treated. 

In this 15 days , I also learnt how to diagnose and counsel the patients with psychiatric disorders and the treatment given. 



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