INTERNSHIP ASSESSMENT

 RITHIKA MUKKAWAR

Roll no : 120

I was posted in General Medicine from 14/4/23 to 12/6/23 in which firstly i was in peripheral postings.

ICU :

I was posted in icu for the first 5days in which there were a many number of cases from which i have learnt many things about those conditions.

I have learnt to monitor critically ill patients and took care of them 

During my duties there was a patient with myositis which got complicated into sepsis ...i have learnt how to diagnose a case of sepsis and management of the same

Learnt to take the abg and interpret it.

There was a patient with ascites for which ascitic tap was done and i learnt the procedure and also the interpretation of the report based on saag whether it was transudative fluid or exudative fluid .

NEPHROLOGY:

I was posted in nephrology for the next 5 days which was a lot hectic during the day time  as there will be hemodialysis for  around 15 patients in toto who were on MHD .....i monitored the patients blood pressure....usually these patients have high blood pressure because of renal failure and fluid overload 

I saw 3 central line procedures and assisted in one .

I tried to understand the basic mechanism of dialysis machine 

I came to know the complications faced by the patients during the hemodialysis and also helped in its management.

WARD : 

Took blood samples.

Gave IV and IM injections.

I helped creating pajr groups of few icu , amc patients.

I updated the fever charts and investigation charts.

UNIT DUTIES:

I was posted in 6th unit and had an opportunity to work under Dr.Prachethan(PGY1) and Dr.Pavan(PGY2)

Case 1 :

https://rithikamukkawar113.blogspot.com/2023/05/85-m-with-altered-behaviour-with-type-2.html?m=1

This was a case of 85 male with acute cva with vascular dementia

 -Did a cns examination for this case with our pg's

-Learnt how to proceed with a case of cva.

-What treatments are given and tried to understand why they are preferred.

-I put a ryles tube for this case.

-I put a foleys catheter for this patient.

-Learnt types of dementia.

-Did a pajr group and updated soap notes in them .

- followed up the case

Case 2 : 

This was a case of 75 male came with complaints of giddiness since 3 years

https://rithikamukkawar113.blogspot.com/2023/06/75-male-with-giddiness.html?m=1

-I learnt how a case of giddiness is evaluated and how to get to a diagnosis.

-Learnt the management of osteoarthritis.

-Learnt to do dix hallpike maneuver.

Case 3 :

https://rithikamukkawar113.blogspot.com/2023/06/52-female-with-pyrexia-and-body-pains.html?m=1

-I drew fever charts for this patient and learnt types of fever .

-Learnt to evaluate a case of fever and what investigations to be sent to get to a diagnosis based on symptoms.

Case 4 :

https://rithikamukkawar113.blogspot.com/2023/06/24-year-old-female-with-fever-and-sob.html?m=1

- This was a case of 24 year old who was diagnosed to have asthma 

-This case was diagnosed based on symptoms as she was having sob , cough episodes during the winter seasons and aggravated in cold environments .

-I learnt how important it is to take a proper history to get to a correct diagnosis.

-Explained the patient how to use a DPI rotahalors.

Case 5 :

https://rithikamukkawar113.blogspot.com/2023/05/70-y-male-with-bl-knee-pains-and.html?m=1

Learning points:

-Peripheral neuropathy and its causes.

In our unit there was a case of 22 year old male with involuntary movements and head movements.

For this case i learnt

- Types of tremors and how are they differentiated .

- learnt about Marfans syndrome as the patient's arms span was a little more than height and he had hyperflexibility in joints.

- bobble head movements and its cause.

Case 6:

https://rithikamukkawar113.blogspot.com/2023/05/45-female-with-giddiness.html?m=1

OPD DUTIES:

-Took histories of many patients 

-Learnt to manage cases like hypertension, Diabetes Mellitus , headache .

-Audited histories of many patients in opd 

CASUALTY DUTIES:

During one of my casualty night duty a patient came to casualty with chest pain which was radiating to left shoulder...

In the ecg there were st elevations in V1- V 6 leads and the troponin I levels were also highly elevated and the patient was diagnosed to have anterior and lateral wall MI ...we gave the patient stat doses of aspirin , atorvastatin and clopidogrel.

Learnt about MI  and its management from this case.

We referred the patient as we donot have an angio here .

PSYCHIATRY POSTINGS :

After my unit duties i was posted in psychiatry posting for 15 days were i learnt how to take detailed history and helped in counselling the patients. 

-Witnessed different psychiatric illness like 

Generalised anxiety disorder 

Depression.

OCD

Psychosis 

Alcohol dependence syndrome 

Tobacco dependance syndrome

Schizophrenia

Attention deficit Hyperactive disorder