Monday, March 15, 2021

Medicine paper for March 2021 bimonthly blended assessment


 Answer all questions                                                      

Max Marks: 100 (10 marks for each  answer) 

Submit by:                                

Date: 16/02/2021 9:00 AM 

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/2021/02/blended-bimonthly-assessment-dec-2020.html?m=1

And 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 current "assignment/question paper" 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 around sharing your experiences can be seen here: https://onedrive.live.com/view.aspx?resid=4EF578BAE67BA469!4180&ithint=file%2cdocx&authkey=!AOy7BpRTn42DBMo


Questions:


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


a). What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings?How specific is his dilated superficial Abdominal vein in making diagnosis?

b) What is the etiology of the current problem and how would you as a member of the treating team arrive at a diagnosis? What is the cause of his hypoalbuminemia?Why is the SAAG low?

c)Will PT,INR derangement preceed hypoalbuminemia in liver dysfunction??Share reference articles if any!

d)What is the etiology of his fever and pancytopenia?

e)Can there be conditions with severe hypoalbuminemia but no pedal edema? Can one have hereditary analbuminemia and yet have minimal edema? Please go this article https://www.frontiersin.org/articles/10.3389/fgene.2019.00336/full and answer the question. 

f) What is the efficacy of each of the drugs listed in his current treatment plan


QUESTION 2

45year old female with abdominal distension


a). What is the problem representation of this patient and what is the anatomical localization for her current problem based on the clinical findings?

b) What is the etiology of her refractory ascites and pleural effusion? and how would you as a member of the treating team arrive at a diagnosis?

c) Approach to a patient with ascites?Clinically is there any way to differentiate pre hepatic, post hepatic and hepatic causes?


d)Causes of budd chiari syndrome?Why did the patient undergo bone biopsy?

d) Management strategies for refractory ascites and Budd chiari syndrome? Share the potential advantages and disadvantages of Peritoneal dialysis catheter placement in refractory ascites?

e) What is the efficacy of each of the drugs listed in his current treatment plan 

f)What is the current outcome?and what could be the etiology of her current outcome?

QUESTION 3

55year old male with SOB and abdominal distension,orthopnea


a). What is the problem representation of this patient and what is the anatomical localization for his current problem based on the clinical findings?

b) What is the etiology of his ascites? and how would you as a member of the treating team arrive at a diagnosis?Chart out the sequence of events!

c)What is the efficacy of each of the drugs listed in his treatment plan?

d)What are his current outcomes ?


QUESTION 4

4)Please go through the thesis presentation below and answer the questions below by also discussing them with the presenter


a)What was the research question in the above thesis presentation? 


b) What was the researcher's hypothesis? 


c)What is the current available sensitivity and specificity of SAAG in diagnosis of etiology of ascites

5) Journal club questions on Ascites theme 

a) Please identify the study design and outcomes in the article linked here https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6644216/ as well as the thesis linked here https://chandanavishwanatham19.blogspot.com/2021/03/of-thesis-clinical-profileevaluationdia.html

b) Please download the CASP diagnostic study checklist here https://casp-uk.net/casp-tools-checklists/ to evaluate the paper here https://www.hindawi.com/journals/ijh/2019/8546010/ and share your learning points on critical appraisal of the paper. 

c) Please evaluate this randomized controlled trial on different techniques at ascitic tap here: https://pubmed.ncbi.nlm.nih.gov/28233752/ also after downloading the randomized controlled trial CASP checklist here https://casp-uk.net/casp-tools-checklists/

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