My experiences with general cellular and neural cellular pathology in a case based blended learning ecosystem's CBBLE "

 Hello everyone

Greetings

I am Dr.Afeefa farzana,Intern from INDIA  

I want to present a compilation of cases that I came across during my journey as a MBBS student during my postings

Disclaimer

This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input.

This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome.

I joined MBBS in 2018 during our first proff we didn't have much exposure clinical side as we were focused on understanding physiology,anatomy,biochemistry 

In the year 2019 during our 3 semester first day of our clinical postings in the Department of General medicine our HOD have enlightened us that medicine is compilation of anatomy, physiology,biochemistry, pharmacology and pathology.rather than thinking medicine as a subject we started applying our knowledge from the pre and para clinical subjects in understanding the disease process and the patient suffering 

The very first patient I saw was a case of 60 year old male c/o bradykinesia,rigidity, tremors and was diagnosed as parkinsonism I was very much surprised to corelate our theoretical knowledge 

There comes the reign of covid 19 we all were forced to sit at homes and were distanced from clinical learning 

Then our seniors started making blogs of patients which helped us to understand what patient is going through

All thanks to our HOD for starting the idea of making blogs 

Taking the detailed history of patietnts ,Sequence of events, how the disease has changed the life style of an individual have helped us to understand the severity and suffering of the patient 

I would like to share a case which I presented for my pre finals

This is a case of 19 year old who is intermediate second year student came to general medicine OPD with chief complaints of

Fever since 3 days

Lower back ache since 3 days

Generalized weakness since 3 days

Patient was apparently asymptomatic 10 days back then he developed high grade fever which was continuous ,no diurnal variation which got relieved on medication given by local RMP [some IV medication was given for 1 day and oral medication for 3 days].

Now again since 3 days he had high grade fever which was continuous not associated with chills and rigor ,no diurnal variation

He had one episode of vomiting today which was non projectile contained food particles

He also complained of low back ache since 3 days which is insidious in onset ,gradually progressive, and is persistent and pain increased during inspiration and no relieving factors.[he was unable to describe the character of pain]

He also complained of abdominal pain which is insidious in onset persistent not associated with nausea and vomiting

He also complained of generalized weakness since 3 days 

No history of burning micturition, increased frequency of urine ,difficulty to pass urine ,nocturnal eneursis

No history of loose stools 

https://afeefafarzanarollno9.blogspot.com/2022/11/19-year-old-male-with-fever-and-lower.html

During our discussion the question which was left un answered was why is the patient who is having dengue fever should have low back ache ?is it because of serositis?? If it was due to pyelonephritis why only Unilateral why not bilateral?

Here is an other case

This is a case of 38 year old male came to gm OPD with chief complaints of pain abdomen and retrosternal burning sensation  since 7  years

Patient was apparently asymptomatic 15 years ago then he developed  abdominal pain which is diffuse,squeezing type of pain,insidious in onset,intermittent associated with alternating constipation and  loose stools and generalised weakness since 15 years

History of blood passed in stools occasionally since 15 years

Patient also gives complaints of retrosternal  burning sensation associated with nausea since 15 years

History of belching present

History of fever on and off

History of significant weight loss

No history of vomitings

https://afeefafarzanarollno9.blogspot.com/2023/05/38-years-male-pain-abdomen-under.html

His pain abdomen is still under evaluation since 7 years.all necessary investigations were done but nothing could evaluate his pain abdomen

Is it ulcerative colitis ?? For how long is the patient going to have pain abdomen??is there any way we could help him out??

Here is an interesting case

https://afeefafarzanarollno9.blogspot.com/2023/03/1801006002-long-case.html

Was it a TIA? If it was then there should be a complete recovery within 24 hrs ?why there is slurring of speech for more than 24 hrs ??

This patient had taught me the entire chapter of stroke ,CNS examination 

This is other case of stroke 

https://afeefafarzanarollno9.blogspot.com/2023/05/75f-recent-altered-sensorium-right.html

There was Restriction of movements of her head towards left.she was unable to turn her head towards left

This was the prevost sign 

In both the cases there was involvement of occipital lobe bit with different manifestations

Here is an interesting case of stoke along with seizures

https://afeefafarzanarollno9.blogspot.com/2023/05/55f-involuntary-movements-of-ul.html

Why has the infarct turned hemorrhagic??

Why was her seizures not controlled even after a week of treatment?

This I just the beginning of my learning and I am quite satisfied to be a part of our general medicine team which is seriously dedicatedly struggling to solve problems of every patient seen both in OPD and IP

I will try to extend this idea of making blogs and sharing the problems of patients in other departments too

Hope you have enjoyed reading this article

Looking forward for the suggestions and solutions to the above queries

Regards,

Dr.Afeefa farzana