1) Covid 19 with co morbidity (Pulmonology/Rheumatology)
Possible questions:
1) How does the pre-existing ILD determine the prognosis of this patient?
2) Given the history of autoimmune disease in the patient, how does the administration of steroids for COVID affect her RA and hypothyroidism?
3) Would this patient have an increased risk for post covid autoimmune response compared to patients without a history of autoimmune disease?
4) Why was she prescribed clexane (enoxaparin)?
2) Covid 19 with Diabetes
Link to the patient case report log:
Questions:
1) Since patient didn't show any previous characteristic diabetes signs, did the Covid-19 infection aggravate any underlying condition and cause the indolent diabetes to express itself? If so what could be the biochemical pathways that make it plausible?
2) Did the patient's diabetic condition influence the progression of her pneumonia?
3) What is the role of D Dimer in the monitoring of covid? Does it change management or would be considered overtesting?
3) Covid 19 Severe
Link to the complete case report log:
Questions:
1. Why was this patient given noradrenaline?
2. What is the reason behind testing for LDH levels in this patient?
3. What is the reason for switching from BiPAP to mechanical ventilation with intubation in this patient? What advantages did it provide?
4) Covid 19 Mild
Link to the case report log:
Questions:
1. Is the elevated esr due to covid related inflammation?
2. What was the reason for this patient's admission with mild covid? What are the challenges in home isolation and harms of hospitalization?
5) Covid 19 and comorbidity (Altered sensorium, azotemia, hypokalemia)
Link to the case report log:
Questions:
1) What was the reason for coma in this patient?
2) What were the competency gaps in hospital 1 Team to manage this intubated comatose patient that he had to be sent to hospital 2? Why and how did hospital 2 make a diagnosis of hypokalemic periodic paralysis? Was the coma related?
3) How may covid 19 cause coma?
6) Severe Covid 19 with altered sensorium
Link to the case report log:
1. What was the cause of his altered sensorium?
2. What was the cause of death in this patient?
7) Covid 19 Moderate with ICU psychosis
Link to the case report log:
Questions :
What is the grade of pneumonia in her?
What is the ideal day to start steroids in a patient with mild elevated serum markers for COVID ?
What all could be the factors that led to psychosis in her ?
In what ways shall the two drugs prescribed to her for psychosis help ?
What all are the other means to manage such a case of psychosis?
What all should the patient and their attendants be careful about ( w.r.t. COVID )after the patient is discharged ?
What are the chances that this patient may go into long covid given that her "D Dimer" didn't come down during discharge?
8) Covid 19 Moderate
Link to the complete case report log
Questions:
1. Can psoriasis be a risk factor for severe form of COVID?
2. Can the increased use of immunomodulatory therapies cause further complications in the survivors?
3. Is mechanical ventilation a risk factor for worsened fibroproliferative response in COVID survivors?
9) Covid with de novo Diabetes
Link to Case report log:
•What is the type of DM the patient has developed ?(is it the incidental finding of type 2 DM or virus induced type 1DM )?
•Could it be steroid induced Diabetes in this patient?
10) Comparing two covid patients with variable recovery
Case report log: https://vidya36.blogspot.
What are the known factors driving early recovery in covid?
11) Covid moderate with first time detected diabetes:
Link to Case report log :
Questions-
1) How is the diabetes related to the prognosis of COVID patients? What are the factors precipitating diabetes in a patient developing both covid as well as Diabetes for the first time?
2) Why couldn't the treating team start her on oral hypoglycemics earlier?
12) Moderate to severe covid with prolonged hospital stay:
Questions :-
1) What are the potential bioclinical markers in this patient that may have predicted the prolonged course of her illness?
13) Severe covid with first diabetes
Link to Case report log :
What are the consequences of uncontrolled hyperglycemia in covid patients?
Does the significant rise in LDH suggests multiple organ failure?
What is the cause of death in this case?
14) Long covid with sleep deprivation and ICU psychosis
Link to Case report log:
Questions:
1)Which subtype of ICU psychosis did the patient land into according to his symptoms?
2)What are the risk factors in the patient that has driven this case more towards ICU pyschosis?
3)The patient is sleep deprived during his hospital stay..Which do u think might be the most propable condition?
A) Sleep deprivation causing ICU pyschosis
B) ICU psychosis causing sleep deprivation
4) What are the drivers toward current persistent hypoxia and long covid in this patient?
15) Moderate Covid with comorbidity (Trunkal obesity and recent hyperglycemia)
Link to Case report Log:
QUESTIONS:
1. As the patient is a non- diabetic, can the use of steroids cause transient rise in blood glucose?
2. If yes, can this transient rise lead to long term complication of New-onset diabetes mellitus?
3. How can this adversely affect the prognosis of the patient?
4. How can this transient hyperglycemia be treated to avoid complications and bad prognosis?
5. What is thrombophlebitis fever?
6. Should the infusion be stopped inorder to control the infusion thrombophlebitis? What are the alternatives?
16) Mild to moderate covid with hyperglycemia
QUESTIONS:
1. What could be the possible factors implicated in elevated glycated HB ( HBA1c ) levels in a previously Non-Diabetic covid patient?
2. What is the frequency of this phenomenon of New Onset Diabetes in Covid Patients and is it classical type 1 or type 2 or a new type?
3. How is the prognosis in such patients?
4. Do the alterations in glucose metabolism that occur with a sudden onset in severe Covid-19 persist or remit when the infection resolves?
5) Why didn't we start him on Oral hypoglycemic agents earlier?
17) Covid 19 with hypertension comorbidity
1)Does hypertension have any effect to do with the severity of the covid infection.If it is, Then how?
2)what is the cause for pleural effusion to occur??
18) Covid 19 with mild hypoalbuminemia
QUESTIONS:
1. What is the reason for hypoalbuminemia in the patient?
2. What could be the reason for exanthem on arms? Could it be due to covid-19 infection ?
3. What is the reason for Cardiomegaly?
4. What other differential diagnoses could be drawn if the patient tested negative for covid infection?
5. Why is there elevated D-Dimer in covid infection? What other conditions show D-dimer elevation?
20) Covid 19 with first time diabetes
Questions:
1)Can usage of steroids in diabetic Covid patients increases death rate because of the adverse effects of steroids???
2)Why many COVID patients are dying because of stroke though blood thinners are given prophylactically???
3)Does chronic alcoholism have effect on the out come of Covid infection????
If yes,how??
21) Severe Covid with Diabetes
Questions-
1. What can be the causes of early progression and aggressive disease(Covid) among diabetics when compared to non diabetics?
2. In a patient with diabetes and steroid use what treatment regimen would improve the chances of recovery?
3. What effect does a history of CVA have on COVID prognosis?
23) Covid 19 with multiple comorbidities:
1) What do you think are the factors in this patient that are contributing to his increased severity of symptoms and infection?
2) Can you explain why the D dimer levels are increasing in this patient?
3) What were the treatment options taken up with falling oxygen saturation?
4) Can you think of an appropriate explanation as to why the patient has developed CKD, 2 years ago? (Note: Despite being on anti diabetic medication, there was no regular monitoring of blood sugar levels and hence no way to know for sure if it was being controlled or not)
No comments:
Post a Comment