Medicine question paper for December 2020 bimonthly blended summative assessment

Below is an online formal question paper to be answered online using all available resources at your online disposal over a period of days and E logged in a manner demonstrated by past examinees in the link here https://medicinedepartment.blogspot.com/2020/11/blended-bimonthly-assessment-oct-nov.html?m=0

 Answer all questions                                                      

Max Marks: 100 (10 marks for each first seven questions and 30 marks for the last question) 

Submit by:                                

Date: 16/12/2020 9:00 AM 

Here is a sample answer paper from the last exam here: https://ashiness3.blogspot.com/2020/11/bimonthly-assessment-for-month-of.html?m=1 please note that every logged answer paper should contain the link to this page and the patient context for each answer as well as avoid plagiarism as illustrated in the sample answer paper. 

A sample answer to the last question number 8 around sharing your experiences can be seen here: https://onedrive.live.com/view.aspx?resid=4EF578BAE67BA469!4180&ithint=file%2cdocx&authkey=!AOy7BpRTn42DBMo

Questions:

Please go through the patient data in the links below and answer the following questions:

1) A 55 year old man with Recurrent Focal Seizures

Detailed patient case report here: http://ushaindurthi.blogspot.com/2020/11/55-year-old-male-with-complaints-of.html

1. What is the problem representation of this patient and what could be the anatomical site of lesion ?

2. Why are subcortical internal capsular infarcts more common that cortical infarcts?

3. What is the pathogenesis involved in cerebral infarct related seizures?

4. What is your take on the ecg? And do you agree with the treating team on starting the patient on Enoxaparin?

5. Which AED would you prefer?

If so why?

Please provide studies on  efficacies of each of the treatment given to this patient.

Question 2) 55 year old man with Recurrent hypoglycemia

Patient details in the intern logged online case report here: http://manojkumar1008.blogspot.com/2020/12/shortness-of-breath-with-high-sugars.html

Questions:

1. What is the problem representation for this patient? 

2. What is the cause for his recurrent hypoglycemia? And how would you evaluate? 

3. What is the cause for his Dyspnea? What is the reason for his albumin loss?

4. What is the pathogenesis involved in hypoglycemia ?

5. Do you agree with the treating team on starting the patient on antibiotics? And why? Mention the efficacies for the treatment given.

3)

A. 41 year old man with Polyarthralgia

Case details here: https://mahathireddybandari.blogspot.com/2020/11/41m-with-chest-pain-and-joint-pains.html?m=1

1. How would you evaluate further this patient with Polyarthralgia?

2. What is the pathogenesis involved in RA?

3. What are the treatment regimens for a patient with RA and their efficacies?

B. 

75 year old woman with post operative hepatitis following blood transfusion

Case details here: https://bandaru17jyothsna.blogspot.com/2020/11/this-is-online-e-log-book-to-discuss.html

1.What are your differentials for this patient and how would you evaluate?

2. What would be your treatment approach? Do you agree with the treatment provided by the treating team and why? What are their efficacies?

4) 60 year woman with Uncontrolled sugars

http://manojkumar1008.blogspot.com/2020/12/60-yr-old-female-with-uncontrolled.html

1. What is the problem representation of this patient?

2. What are the factors contributing to her uncontrolled blood sugars?

3. What are the chest xray findings?

4. What do you think is the cause for her hypoalbuminaemia? How would you approach it?

5. Comment on the treatment given along with each of their efficacies with supportive evidence.

5) 56 year old man with Decompensated liver disease

Case report here:  https://appalaaishwaryareddy.blogspot.com/2020/11/56year-old-male-with-decompensated.html

1. What is the anatomical and pathological localization of the problem?

2. How do you approach and evaluate this patient with Hepatitis B?

3. What is the pathogenesis of the illness due to Hepatitis B?

4. Is it necessary to have a separate haemodialysis set up for hepatits B patients and why?

5. What are the efficacies of each treatment given to this patient? Describe the efficacies with supportive RCT evidence. 

6) 58 year old man with Dementia

Case report details: http://jabeenahmed300.blogspot.com/2020/12/this-is-online-e-log-book-to-discuss.html

1. What is the problem representation of this patient?

2. How would you evaluate further this  patient with Dementia?

3. Do you think his dementia could be explained by chronic infarcts?

4. What is the likely pathogenesis of this patient's dementia?

5. Are you aware of pharmacological and non pharmacological interventions to treat such a patient and what are their known efficacies based on RCT evidence?

7) 22 year old man with seizures

Case report here http://geethagugloth.blogspot.com/2020/12/a-22-year-old-with-seizures.html

1. What is the problem representation of this patient ? What is the anatomic and pathologic localization in view of the clinical and radiological findings? 

2. What the your differentials to his ring enhancing lesions?

3. What is "immune reconstitution inflammatory syndrome IRIS and how was this patient's treatment modified to avoid the possibility of his developing it?

 8) Please mention your individual learning experiences from this month.