Medicine daily activities .
June 5 2020 :
K.Vaishnavi GM Y1 PG ATTENDANCE FROM MAY 15 -MAY 31 :
I was posted in ICU department in the month of May .
MEDICAL LEAVE - NA
CASUAL LEAVE - 0
-MAY 15 - It was my night shift and was managing ventilator case which was a ckd pt with right LL pneumonia and pulmonary edema who got intubated previous day . Also managed an hypertensive emergency case along with nephrology pg .
May 16 - Examined paraparesis case .
Placed Central line for one of our CKD patients .
MAY 17- Sunday rounds for icu and amc patients . Tried extubating ckd case and put him on T piece .He maintained for few hours but as saturation was not maintaing we had to intubate him again.
MAY 18 - Followed ICU and AMC rounds. Took brief history of a 30 yr old male with heart failure with PAH and hypogonadism .Read about whether low testosterone levels is related to high risk of PAH ,which was shared by one of our interns .
Patients with PAH also had lower testosterone (8.63 vs 14.13 ng/mL; P =.02) and progesterone (0.32 vs 0.68 ng/mL; P <.001) levels compared with controls.
Having higher estradiol and estradiol/testosterone levels was significantly associated with an increased risk for PAH (odds ratio per ln estradiol, 3.55; P <.001; odds ratio per ln estradiol/ testosterone, 4.30; P <.001). Conversely, having higher testosterone and progesterone were both associated with a reduced risk for PAH (odds ratio per ln testosterone, 0.48; P =.003; odds ratio per ln progesterone, 0.09; P <.001).
May 19 - Managed a ckd case on MHD with hyperkalemia along with nephrology pg .Followed icu and AMC rounds .
MAY 20 - Managed a mitral stenosis patient with heart failure who was in Atrial fibrillation when she was shifted to ICU .
So she was given loading dose 150mg of AMIODARONE followed by infusion .monitored patient .
Followed icu and AMC rounds.
May 21 - Followed ICU and AMC rounds .
Examined a paraparesis case which got admitted . Read about Gillian barre syndrome .
May 22- Followed icu and AMC rounds .
Took brief history of unit case which got admitted ..initially thought of recurrent cva ,but later it was diagnosed as neuromyelitis optica . Reviewed literature on it.
May 23 -Followed icu and AMC rounds .
Took brief history of a DKA patient and started him on IV insulin and IV fluids .
May 24 - Followed icu and AMC rounds .
Managed an acute pulmonary odema case along with nephrology pg.
May 25 - Examined cases which got admitted that day and monitored .
May 26 - Managed an acute hypovolemic shock patient secondary to gastroenteritis who got admitted late night.
May 27 - Managed an heart failure patient who was in shock and oliguria . And early morning had hyperkalemia with tall tented T waves .Nebulizations with salbutamol ,IV insulin in 25%D and 10 ml 10 % calcium gluconate IV was given .
May 28 - Rounds for icu and amc patients .
Managed an Left gluteal abscess case with left lower limb cellulitis and AKI secondary to sepsis . Reviwed literature on common organisms causing and treatment of cellulitis.
May 29 - Rounds for icu and amc patients .Reviewed literature on peripheral neuropathy.
May 30 - Took brief history of a peurperium female who presented with chestpain but on evaluation had acute renal failure and bilateral pyelonephritis .
May 31- Followed ICU and AMC rounds . Tried placing a central line but wasn't successful as patient was moving constantly so took help of emd pg .
Placed Central line for one of our CKD patients .
MAY 17- Sunday rounds for icu and amc patients . Tried extubating ckd case and put him on T piece .He maintained for few hours but as saturation was not maintaing we had to intubate him again.
MAY 18 - Followed ICU and AMC rounds. Took brief history of a 30 yr old male with heart failure with PAH and hypogonadism .Read about whether low testosterone levels is related to high risk of PAH ,which was shared by one of our interns .
Patients with PAH also had lower testosterone (8.63 vs 14.13 ng/mL; P =.02) and progesterone (0.32 vs 0.68 ng/mL; P <.001) levels compared with controls.
Having higher estradiol and estradiol/testosterone levels was significantly associated with an increased risk for PAH (odds ratio per ln estradiol, 3.55; P <.001; odds ratio per ln estradiol/ testosterone, 4.30; P <.001). Conversely, having higher testosterone and progesterone were both associated with a reduced risk for PAH (odds ratio per ln testosterone, 0.48; P =.003; odds ratio per ln progesterone, 0.09; P <.001).
May 19 - Managed a ckd case on MHD with hyperkalemia along with nephrology pg .Followed icu and AMC rounds .
MAY 20 - Managed a mitral stenosis patient with heart failure who was in Atrial fibrillation when she was shifted to ICU .
So she was given loading dose 150mg of AMIODARONE followed by infusion .monitored patient .
Followed icu and AMC rounds.
May 21 - Followed ICU and AMC rounds .
Examined a paraparesis case which got admitted . Read about Gillian barre syndrome .
May 22- Followed icu and AMC rounds .
Took brief history of unit case which got admitted ..initially thought of recurrent cva ,but later it was diagnosed as neuromyelitis optica . Reviewed literature on it.
May 23 -Followed icu and AMC rounds .
Took brief history of a DKA patient and started him on IV insulin and IV fluids .
May 24 - Followed icu and AMC rounds .
Managed an acute pulmonary odema case along with nephrology pg.
May 25 - Examined cases which got admitted that day and monitored .
May 26 - Managed an acute hypovolemic shock patient secondary to gastroenteritis who got admitted late night.
May 27 - Managed an heart failure patient who was in shock and oliguria . And early morning had hyperkalemia with tall tented T waves .Nebulizations with salbutamol ,IV insulin in 25%D and 10 ml 10 % calcium gluconate IV was given .
May 28 - Rounds for icu and amc patients .
Managed an Left gluteal abscess case with left lower limb cellulitis and AKI secondary to sepsis . Reviwed literature on common organisms causing and treatment of cellulitis.
May 29 - Rounds for icu and amc patients .Reviewed literature on peripheral neuropathy.
May 30 - Took brief history of a peurperium female who presented with chestpain but on evaluation had acute renal failure and bilateral pyelonephritis .
May 31- Followed ICU and AMC rounds . Tried placing a central line but wasn't successful as patient was moving constantly so took help of emd pg .
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