Date : 20/12/21 , Monday - Theory*
Case presentation by final year MBBS student .
*Elog link :*
Attended by Dr Durga krishna pgy2
Dr Rashmitha pgy3
Dr sushmitga pgy3
2-4 pm Theory
36 year old female with Unicornuate uterus with ?Ovarial failure
Discussed about utility of MRI in diagnosing the Unicornuate uterus vs Cornual block
Attended by Dr Durga krishna pgy2
Dr Rashmitha pgy3
Dr sushmitha pgy3
*Date 21/12/21, Tuesday - Seminar*
*Elog link* :
2-4 pm Seminar
40 year old female with cirrhosis of liver secondary to NAFLD, metabolic syndrome
Pathophysiology of metabolic synrome causing NAFLD cirrhosis of liver, portal hypertension.
“The diagnostic performance of MR elastography in liver fibrosis staging was similarly high in the groups with and without CHB, but the cutoff LS values for diagnosing liver cirrhosis differed between the groups with and without CHB.”
Presented by Dr Moulika internee
Attended by Dr Durga krishna pgy2
Dr Rashmitha pgy3
Dr sushmithapgy3
*Date 22/12/21, Wednesday,- Journal club*
*Elog link:*
Attended by Dr DK pgy2
Dr Rashmitha pgy3
Dr sushmitha pgy3
Date 23/12/21, Thursday, - Internship training program for interns - Tutorial
Presenters :
1) Moulika
2) Huda
*Presentation videos*:
Elog link :
Questions raised
Causes of post dialysis infections Infections
Pathophysiology of NSAID induced Renal failure
There are not many studies yet showing the long-term effects of NSAIDs on the development of chronic kidney disease (CKD). However, it has been shown that daily use for more than one year increases the risk of developing CKD.14
There may be progression in patients who do not discontinue NSAIDs when they develop acute interstitial nephritis and interstitial fibrosis.5"
Attended by 2016 interness
Dr DK pgy2
Dr rashmitha pgy3
Dr Sushmitha pgy3
24/12/2021 Friday Group discussion
2-4pm class
Why does recurrent hypoglycemia in liver mets
Some patients present with hypoglycemia and liver metastases; among them, only a few develop hypoglycemia as a result of a failure of hepatic glucose production. Most develop hypoglycemia as a result of an insulin-mediated process--either the secretion of insulin by an islet-cell tumor or the secretion of insulin-like growth factor-II by an extrapancreatic tumor.
Three patients had an insulinoma and four had non-islet cell tumor hypoglycemia (NICTH) due to hepatocellular carcinoma, colon carcinoma, meningeal sarcoma, and hemangiopericytoma, respectively. All of the patients had liver metastases
Glucagon stimulation test (serial glucose measurements after a 1 mg infusion of glucagon) as part of the workup for hypoglycemia were retrospectively reviewed. Those patients whose test revealed a rise in serum glucose of >30 mg/ dL were subsequently treated as outpatients, with a continuous glucagon infusion delivered by a portable pump.
Why does recurrent hypoglycemia occurs in patient with Liver mets
1. All patients with insulinoma responded to glucagon with a rise in blood serum glucose levels, indicating adequate glycogen stores.
2. The four patients with NICTH had mixed responses: in two patients, the response suggested that hypoglycemia was due to an insulin-like tumor product;
3.glucose levels did not rise in the other two cases, indicating that hypoglycemia was due to poor hepatic glycogen reserve/liver failure.
In all cases, a glycemic response to glucagon predicted good response to long term treatment with glucagon (0.06-0.3 mg/hour, via intravenous infusion pump).
Dr DK pgy2
Dr rashmitha pgy3
Dr Sushmitha pgy3
