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Internship assessment—general medicine department

 I, b.manaswini  intern of 2k17 batch  was posted in department of general medicine on dates 02/01/23 to 03/03/23 including psychiatry  from dates 15 jan to 30 jan  General medicine was my first posting in internship and reported enthusiastically on date and alloted unit 1 under pgs  dr. Prachethan and dr vivek sir . I took a little bit of time to cope up with process but got set by 1 week  On the very first day i monitored blood transfusion whose hb was 6mg/dl until 9pm on non duty day, after that patient was taken over by obs gyn department for some gynaecological issues . On op day there were nearly 70 pts and recorded nearly 30 patients vitals and among them few are admitted  My very first case was very intrested pt presented with slurring of speech and decresed tone she got admitted and i took interest in that case from starting to end till dicharged . This case also helped me to diagnose my friends  mother who presented with same symptoms even before admitted into hospital.  Here
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38 yr old with c/o epigastric pain

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38y old male came to causality with  Clo of epigastric pain since yesterday  Clo of 10 episodes of vomitings since morning, Pt is a known case pancreatitis with alcoholic liver disease with h/o necrotising pancreatitis  Pt was apparently alright 30 days back and then developed vomitings immediately after food intake , contained food particles non bilious non blood stained and abdominal pain since 10 days and was admitted in our hospital treated symptomatically and discharged. Patient was admitted in outside hospital to get ct dine one week ago. Today pt was presented to causality with complaints of epigastric pain since yesterday which is insidious in onset and gradually progressive dragging type and non radiating aggravated on taking food and relieved on taking alcohol. K/c/o Dm-II since 2 months and on tab glimi  Psychiatrist consultation i/v/o alcohol dependence  Ophthalmology consultation i/v/o diabetic retinopathy    Investigations chart  
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  c/o pain in theAbdomen since 3days C/o vomitings since 3days (2-3 episodes /day) patient was apparently alright 3 months back Then    he developed similar complaints and was diagnosed as Acute pancreatitis. Patient was advised for abstinence of alcohol.   since 10 days patient started consuming Alcohol and he developed Pain in Abdomen since 3 days. in the Left lumber region, Insidious onset, gradually progressive in nature. Aggravated on sitting position, Relieved on lyingdown. H/o vomitings since 3days (3episodes/day)   Past history  Pt had an h/o accident 8 yrs ago and had fractures on right leg and right arm for which he was treated in our hospital  Rx:  1. Inj. Tramadol in 100ml ns       IV/TID 2.IVF NS RL DNS @ 100ml/hr 3. Inj. PAN 40mg IV /OD 4. Inj. OPTINEURON 1amp in 100ml NS/IV/OD 5. Inj .ZOFER 4mg IV/OD 6. NBM TILL FURTHER ORDERS 7. GRBS MONITORING  Psychiatry consultation i/v/o alcohol dependence  Ophthalmology consultation i/v/o diabetic retinopathy  Ortho opinion i/v/o o
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  88 yrs old Female came to casualty with...... February 22,2023 A  88 yrs old  Female  presented to casualty with C/o  irrelevant talk and altered mental status since 10 days Shortness of Breath since 3 days  Cough since 3 days   HISTORY OF PRESENT ILLNESS: Patient was  asymptomatic 10 days ago and then developed altered mental status on & off and her speech being non cohorent  at times and later becoming normal by herself , each episode  lasting for 10- 15 mins . Productive cough 2 days ago  Now dry cough Shortness of breath since  3 days  initially grade III progressed  grade IV in these  3 days.  Later went to outside hospital and 2 D echo was done   2 D echo ( CAD , LAD + territor) , Global Hypokinesia , Severe LV dysfunction  No history of chest pain , palpitations , giddiness.  On 20/02/23 presented to causality with complaints of loss of appetite since one day and not talking to anyone since morning as informed by attender . So they took her to hospital and s.electrolytes w
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