INTERNSHIP ASSESSMENT

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 INTERNSHIP ASSESMENT 

Posted in department of general medicine from 12/12/22 to 11/2/23 

GUMUDALA VISHAL 

ROLL NO :- 50

I was posted  fisrt in Pyschiatry department  (12-12-22 to 26/12/22)

=> learned about the importance of history taking its role in management of the disease

=> I have seen and learnt a few cases 

    1 Alcohol dependence syndrome

    2 Tobacco dependence syndrome 

    3 schizophrenia 

    4 Depression 

    5 bipolar disorder 

learnt about the audit scoring and did for the patients came to op



Unit duty :- 27/12/22 to 27/1/23


https://gumudalavishal.blogspot.com/2023/01/50-year-old-male-with-dka.html

This is a case of diabetic ketoacidosis 


How is it diagnosed

Complications of diabetic ketoacidosis 

Precipitating factors in the known diabetics 

Sugar trends hourly grbs 

Treatment 

It was treated by correcting the substantial hypovolemia by giving fluids @ 100ml/hr

Hyperglycemia was treated by giving insulin ( Human Actrapid injection) intravenously

hypokalemia is corrected by inj kcl infusion

https://gumudalavishal.blogspot.com/2023/01/46-year-old-female-patient-with-seizures.html

Diagnosis:
1) hypoxic ischemic encephalopathy

2) Generalized status epilepticus secondary to Autoimmune vasculitis- pRES/uremic/ septic encephalopathy
3) pre renal aki on CKD on hemodialysis
4) urinary tract infection
5) Anti synthetase syndrome
6) pulmonary Tb
7)? Invasive aspergillosis
8) post tracheostomy

Learning points :- 
How is patient intubated
How the ventilator modes are converted 
when to extubate the patient (extubation criteria) 
Seizures management




This a case of prerenal AKI
Learning points :- 
What are the prerenal renal postrenal causes 
Management of AKI
Complications of AKI

This is a case of altered sensorium secondary to hyperosmolar hyperglycemic state 

Learning points:- 

Difference between HHS and diabetic keto acidosis 
Acute and chronic complications of diabetes
Types of DM 
Diabetic nephropathy stages 


 This a case of acute kidney injury with grade 3 uterine prolapse 
Learning points :- 
Causes of AKI
Causes of pleural effusion
Min fluid for pleural tap 




Peripherals (27/1/23 to 11/2/23) 

 NEPHROLOGY DUTY:

Assisted Central line and fixed the line with sutures

Drawn samples and collected reports.

Monitered vitals of patient undergoing dialysis.

Monitored vitals of CKD patients.

Typed and printed dischage summaries of patients.

WARD DUTY:

how to approach a case / diagnosing a case based on only clinical history 

asking negative history to rule out other differentials 

Have attended the rounds.

Got SOAP notes updated of ward patients.

ICU DUTY:

Done ascitic tap 

Monitored hourly vitals of ICU and AMC patients.

Learnt drawing of ABG samples from brachial and femoral 

Inserted RYLES tube.

FOLEYS catheterisation .

Placed IV canula.

Done CPR.

Learnt when and how to use defibrillator.

Monitored blood transfusion 


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