My Experience with General Cellular And Neural Cellular Pathology In a Case based Blended Learning Ecosystem's CBBLE

Welcome to my blog! I am Penukonda Daniya Menaz , an enthusiastic medical student from India. Here, I will share fascinating real-life cases that have not only expanded my knowledge of history taking and clinical examination but also improved my patient interaction skills and overall approach to patient care. These cases have been immensely valuable in shaping my medical journey, and I am thrilled to share them with you.

Join me as we explore the captivating world of patient care, where each interaction offers opportunities for learning, personal development, and making a positive impact on the lives of those we serve.

Thank you for embarking on this incredible journey with me!

CBBLE PAJR PARTICIPATORY LEARNING ACTION RESEARCH DISCLAIMER

 NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS/HER GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT.

During the early stages of my medical journey, I had my first opportunity to interact with a patient in fifth semester. . I vividly remember the mixture of excitement and nervousness that coursed through me as I prepared to apply my theoretical knowledge to a real-life scenario.

He was an 50 year old male admitted to OPD with chief complaints of bilateral knee joint pain and swelling of the knee and ankle joint. He was active and oriented to time, place and person. He was self admitted and told me the history of his illness that is pain in joints (initially ankles , knees , wrist and elbows )

 In terms of the hands, the initial pain originated in the wrist, accompanied by swelling and limited flexibility at the metacarpophalangeal joint. Within 1-2 days, the pain shifted to the elbow, resulting in incomplete flexion and swelling. Subsequently, the pain traveled to the shoulder, causing challenges in lifting and abducting the shoulder. This pattern of pain and involvement alternated between the hands, meaning that when one hand was affected, the other remained unaffected.

Concerning the legs, the pain originated in the ankle joint, accompanied by swelling that lasted for 1-2 days. As time passed, the pain progressed to the knee, leading to difficulty in bearing weight and requiring the use of a walking stick or support. Swelling was also observed in the knee joint. Eventually, the pain migrated to the hip joint. Similar to the hands, the leg pain exhibited asymmetry, affecting only one leg while the other leg remained unaffected.After experiencing pain his stopped farming as profession. These pains progressively worsened over time upon detail examination and investigation he had iron deficiency anemia with Rheumatoid Arthritis (Sero negative ) with hyperurecemia.

(Full details in below link)

https://daniyamenazrollno121.blogspot.com/2023/06/50-year-male-with-bl-knee-pain-and.html

This patient's treatment showcased the practical applications of different medicines, giving me a first hand experience of their real-life uses beyond mere theoretical knowledge. 

In addition to the opportunity to learn detailed history taking and clinical examination, I had the privilege of witnessing a Knee Arthrocentesis procedure. This experience allowed me to observe the technique and intricacies involved in this diagnostic and therapeutic intervention.

Following the procedure, I was entrusted with the task of presenting the case in front of my esteemed Head of Department of General Medicine, Respected Dr. Rakesh Biswas Sir, along with my colleagues. The presentation provided a platform for in-depth discussion and analysis of the case.

This case presentation not only provided an excellent platform for learning and sharing knowledge but also fostered an environment of collaborative learning and professional growth

This helped me broaden my understanding of the case and further develop my clinical reasoning skills.

CASE - 2

Recently, I came across another intriguing case that caught my attention. A 70 year old male, labourer by occupation, came to casualty with chief complaints of cough since 5 days, shortness of breath since 5 days and chest pain since 5 days.

The patient's medical history reveals that they were asymptomatic five days prior to the current presentation. However, they subsequently developed a sudden-onset, continuous, and progressively worsening dry cough, predominantly occurring at night. Interestingly, the coughing episodes were accompanied by dark orange-colored vomit, which exclusively occurred during the intake of water. These vomiting episodes were non-projectile, occurring three times a day, and were not associated with any symptoms of nausea or dizziness

The patient's medical history reveals that they were asymptomatic five days prior to the current presentation. However, they subsequently developed a sudden-onset, continuous, and progressively worsening dry cough, predominantly occurring at night. Interestingly, the coughing episodes were accompanied by dark orange-colored vomit, which exclusively occurred during the intake of water. These vomiting episodes were non-projectile, occurring three times a day, and were not associated with any symptoms of nausea or dizziness.

It is important to note that there were no additional symptoms associated with the cough, such as cold symptoms, sore throat, post-nasal drip, sinusitis, acid reflux, hoarseness, stridor, night sweats, or weight loss. However, the patient also experienced a sudden-onset of shortness of breath, graded as a 4 on the Modified Medical Research Council (MMRC) scale, without any symptoms of orthopnea or nocturnal dyspnea. The shortness of breath had no identified aggravating or relieving factors.

Additionally, the patient reported sudden-onset chest pain, which gradually worsened and had a diffuse character, resembling a dragging sensation. The pain radiated from the lower region of the chest upwards towards the back. It intensified during breathing and coughing, with no identified relieving factors. Notably, the chest pain was not associated with symptoms such as palpitations, chest tightness, wheezing, body aches, night sweats, fever, myalgia, or headache.

Further evaluation and investigations led to the diagnosis of tuberculosis and acute bronchitis.

Complete details in the link below .

https://daniyamenazrollno121.blogspot.com/2023/04/70-yr-old-male-with-sob-cough-and-chest.html

As I continue my medical journey, I look forward to more such opportunities to present and discuss cases, as they play a crucial role in refining my clinical skills, expanding my knowledge base, and fostering a culture of continuous learning and improvement.