MY EXPERIENCES WITH GENERAL CELLULAR AND NEURAL CELLULAR PATHOLOGY IN A CASE BASED BLENDED LEARNING ECOSYSTEM'S CBBLE

 MAY 30TH 2023

This in Harthik choppa a medical student from India. Welcome to my blog where you can see how my general medicine changed my view of seeing general medicine as a mere subject which has to be studied for the sake of exams to general medicine being an interesting, immersive journey which covers each and every aspect of our amazing human body. We had an open platform where we could discuss things and we approached our HOD sir and seniors directly many times where our doubts were cleared with an open mind without any judgement. As medical students we learned a lot of different ways to diagnose and treat a patient in different scenarios practically bedside rather than studying books for hours and hours. I am very much excited to share this journey over the past 3 years

Coming to my first case, 

It was a 65 old female who was quite alright when I saw her my first impression on the lady was she is perfectly alright so I was intrigued on why she came to the hospital as I walked closer towards her I could see her hyperventilate the I approached her and asked her problems to which she said she had the complaints of fever, abdominal pain and vomiting. She said she had fever and abdominal pain from 3 days along with shortness of breath from 1 day. There was no notable visible abnormalities in her like pedal edema, pallor etc. The further treatment was done along with investigations. You can take a detailed report of the case in my blog:

https://harthikchopparollno56.blogspot.com/2022/07/65-year-old-female-with-fever-and.html

The diagnosis came to be as diabetic ketoacidosis to which the lady was treated appropriately and sent home.

I made another blog of diabetic ketoacidosis of a different patient in the later time to which you can see the link attached

https://harthikchopparollno56.blogspot.com/2022/08/49-year-old-patient-with-vomitings.html

Coming to the case which showed me how beautiful medicine is..

A 65 year old male came to the department with chief complaints of abdominal pain. As I approached the patient I could see that his abdomen was distended. As I examined him we could come to a conclusion that he had ascites. He had no general examination findings related to liver failure, there was increased liver span in the patient. He had shortness of breath. You can see the case blog below:

https://harthikchopparollno56.blogspot.com/2023/04/60-year-old-male-with-abdominal-pain.html

When we were taking the case and we approached our HOD sir to an interactive session which was very awakening. The discussion was about why do patient with ascites have shortness of breath. It may be simple thinking with a naïve mind that it is due to accumulation of fluid in the abdomen which pushes the diaphragm up causing shortness of breath. It is true in most of the cases but could it have any underlying pathology? My fellow classmate suggested a theory where portal hypertension in ascitic patients may lead to pulmonary hypertension leading to shortness of breath which made me thinking in ascitic patients with liver failure there is hypoalbuminemia which may cause SOB due to osmotic imbalance. I approached sir with this theory to which he praised my and follow it up. As I looked into this I found out that hypoalbuminemia may cause pulmonary edema leading to shortness of breath and liver patients do have hypoalbuminemia but there was no concrete evidence stating that hypoalbuminemia causes shortness of breath in liver failure patients. This got me thinking and I would love to research around this in my future." A simple symptom can have various reasons for its presentation". This discussion made me understand that and how interesting this field is.

Another interesting case

A 60 year old male came to the department with chief complaints of fever and cough since 10 days. We took his history. We could see the patient hyperventilating on speaking for long durations. Then we asked his about this condition to which he responded that he thought that this was normal and thought that it is due to his cough and nothing to worry about. We explained everything to him. Upon examination we could listen crepitations on the lower lobe of left lung, there were decreased chest movements on the left side and on X-ray there was clear defined consolidation. So the patient was being treated for TB and confirmatory tests were ordered. Unfortunately before we could get the results the mass burst leading to sepsis and death. The blog can be found below:

https://harthikchopparollno56.blogspot.com/2023/04/60-year-old-male-with-fever-and-cough.html

This case thought me how quick decisions should be made and how depressing sometimes being a doctor is.

A case which I considered to be difficult turning out be the most interesting case...

As medical students we always used to stay away from neurological cases. At this time I encountered a 27 year old male who came with the complaint of right sided weakness. We carefully took the history and started examination based on how our seniors thought. Upon examination to our astonishment aside from him having various findings we could actually rule out places where the lesion could be and come to rough idea where the lesion could be from mere examination without any investigations. the blog can be found below:

https://harthikchopparollno56.blogspot.com/2023/03/27-year-old-male-with-right-sided.html

This case made my worst nightmare in general medicine to the most interesting thing to deal with in the department.

Throughout this journey I learned a lot from the department:

-I learned how important history taking is and how easy it is to diagnose a patient without investigations and only proper history taking.

-I learned how important examination is and by examination we can 90% be sure and confirm the diagnosis to which we approached by history taking.

-I learned proper bedside etiquette and how to interact with a patient and what are right questions to be asked

I am really glad I got this opportunity to work with the department. Thanks to the department for providing such a space where we could learn a lot of things which will help us throughout the future as medical practitioners.