ONLINE WARDROUNDS (Ep 2): FEATURING Case Reviews AND Special TETE-A-TETE with @Zoneboy!

in #air-clinic6 years ago

Hello Steem Medics,

#AIR-CLINIC ROCKS! It’s good to be back with another interesting episode of Online Wardrounds, a special programme for medics on the blockchain. It is a part of @Air-Clinic's sub-project,
SMSI (steem medics support initiative).
We are sure you had a great time during the first episode. For those that missed the show, here is a link to the first edition

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ATTENDANCE REGISTER (LAST WEEK).

These are the steem medics that graced our grand rounds last week:

You all made our first episode a success. We appreciate your contributions.

FOR THIS WEEK , HERE ARE THE CASES FOR YOU TO ATTEMPT.

Case 1
A 37-year-old woman on presentation said to be bleeding PV with a sudden onset of severe left iliac fossa pain which occurs monthly. Trans-vaginal USS reveals 2 cm echogenic masses seen in the broad ligament.

  • What is your diagnosis? (And what is the basis for making your diagnosis?)
  • What are your DDx?
  • How would you work up this patient?
  • How would you manage this patient?

Case 2
A 45-year-old sheep farmer complains of a headache, anorexia, muscle and joint pain with an ‘undulating’ fever.

  • What is your diagnosis? And what is the basis for making the diagnosis?
  • What are your DDx
  • How would you work up the patient?
  • What are your management modalities for this case?

Remember to approach these cases from your professional point of view.

BENEFITS OF SMSI

  • As the name implies this is strictly to assist steem medics on their steemit journey.
  • Support will be in the form of community of mutual interests.
  • Qualification verification to improve the quality of steem healthcare.
  • Upvotes and post -curation for verified members.
  • Get part of the rewards for participating in Online Wardrounds.
  • Engaging discussions will be held intermittently to listen to our individual journey on the path of health.
  • Problem-solving and family bonding.
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    Rewards distributed for last week's episode.

TETE-A-TETE (INTERVIEW SEGMENT):

For this week’s TETE-A-TETE segment, meet our first guest... @zoneboy in the building.

  • LETS MEET YOU.

I am Ola from Kwara state in Nigeria. I am a graduate of microbiology from Kwasu (Kwara state university) currently in my early 20's.

It's not easy to survive on the Steem Blockchain.
I remember when @eurogee mentioned air-clinic. I knew it's going to be a success because it's like deviating from the norms.The norms being supporting minnows/bring new members into steemit. Air-clinic is different. A clinic on the Steem Blockchain offering health advice to users is something. As a Microbiologist, you can only be proud of that innovation.

My high point on steemit hmmm. I got many but joining the Utopian Team is the highest. I always want to join any project that has the community in mind. Utopian fits in.I don't have any low point. My steemit journey is not a smooth ride though, but I am that guy that doesn't let little things bother him. Once I pour out my mind. It's all over. So no low point

  • CHALLENGES/ SURVIVAL STORY IN YOUR SPECIALTY.

Microbiology is not an easy course. That course is wide. My school did not help matters too, 1-week exam.
I mean all the 12 courses must be completed within 1week. So you have to read before the exam date not just when it's exam time you now start reading. 'That Na fail' . Confam one!
I was able to survive all this by being dedicated and staying true to the game.

  • MOTIVATION TO STUDY YOUR CAREER

When you ask most kids their favorite future job, most will answer I want to be a Doctor. However, when we all become a Doctor, who is going to provide support for the Doctors. Who's going to be the eyes and ears of the Doctor?
These are what motivated me to choose Microbiology.

OTHER INITIATIVES THAT "Steem-Medics" WILL BENEFIT FROM.

  • #AIR-CURIE: is an initiative powered by @Air-Clinic aimed at finding and rewarding quality medical posts. We also submit to giant curators who may further reward posts.

  • #Leading-HEALTH-TALKS: every true health professional/student desires to share their knowledge of medicine and the human body with others. We engage #steem medics in the affairs of @Air-Clinic.You get the opportunity to share knowledge according to your interests and specialty.

Don’t forget to share your interesting case with us; it may be used for a review in our next episode.

We are here for your health!



This article was compiled by @antigenx for @air-clinic

KINDLY UPVOTE & RESTEEM TO REACH MORE MEDICS.

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@air-clinic is definitely growing in leaps and bounds.

I can't wait for the community to have its own token when SMT launch.


Special thanks @antigenx for the interview. You guyz rock.

@zoneboy thanks for consenting to come on the live segment.

@air-clinic appreciates your responses

Thank you for honouring our invite. It was great having you on the show. Cheers!!

Let me (as GP) attempt case 2

My dx is Brucellosis. My basis for diagnosis is typical history of patient being sheep farmer having ** UNDULATING FEVER** with myalgia /arthalgia.

DDX:- Brucellosis, cat scratch disease, typhoid, cryptocosis, histoplasmosis, Mycoplasma pneumonia, TB.

Work-up :-

  • CBC.
  • LFT.
  • RFT.
  • SEROLOGY- HEPATITS , BRUCELLOSIS.
  • WIDAL TEST.
  • SPUTUM/BRONCHIAL WASHINGS FOR AFB.
  • CXR

MANAGEMENT:-
Antipyretics and analgesic like paracetamol.
Antibiotics- Doxycycline is DOC for brucellosis.

You are in order bro @drqamranbashir. I really love your detailed plan for management of the patient.

What information in the history would be also beneficial to look out for?

Thanks a lot bro.
We should seek history of consumption of unpasteurized milk and soft cheeses made from the milk of infected animals.

Very good one again. You are doing very well @drqamranbashir

Awesome, welll detailed plan @drqamranbashir and I definitely agree with you on this case two. What's the dosage incase someone needs to be treated who is currently having to deal with this illness.

Case 1. I think that the most probable diagnosis is endometriosis because of monthly pain plus pelvic mass. The differential diagnosis could be an ectopic pregnancy or pelvic tumor of connective tissue as some kind of sarcoma. This patient has to go to surgical exploration.
Case 2 must be studied as unknown origin fever with diagnosis probable of brucellosis, Lyme disease, rickettsiosis, and malaria, depending on the demographic area.
Neither of both cases is my expertise area but are very interesting and I'd like to know expert opinion

I love your input @endopediatria, lets see if others would come and knock us off with an expert opinion

Yes. These are very interesting activities. I hope a lot of colleagues participate.

Yes ma @endopediatria I really hope so too. And by the way, I love the way you still contribute immensely despite being pediatric endocrinologist. You Rock.

Thanks. Some things never are forgotten. I remember how much I enjoyed discussions at medical school.

Hi. Case 1: it is an endometriosis, because pelvic pain appears with menses. The treatment would be contraceptives to try to reduce the mass and if that doesn´t happen it should be operated.

Case 2: Brucellosis
The diagnosis is based on the fact that brucellosis is an occupational disease of caregivers, veterinarians and those who work in matansa halls. The symptoms are undulant fever, myalgias and arthralgias. The tests to be performed include complete hematology. Blood culture, RP, PLT, 2ME, CT. Treatment includes doxycycline associated with rifampicin.

You are in order @elvigia. What are your differential diagnosis for both cases? And why would you not stick your neck for them?

Case 1: It is not an ectopic pregnancy because it said that it was repeated every month, that is, the pelvic pain appears with each menstruation. in any case I would do a pregnancy test or human gonadotrophin levels.
In Case 2, the differential diagnoses would be Lyme disease, but they do not mention skin lesions in the description. it occurs more in wooded regions, but I don´t know the region where the patient lives.

Online Wardrounds!

Its time for another episode;


Lemme attempt the first case:

Lady likely has Endometriosis. The echogenic masses could be deposits on the peritoneum thus the abd pain and bleeding pv.

If it hasn't exceeded a month, I would say Ectopic pregnancy.

She's going to need the basic investigations, FBC with emphasis on Hb, SEUCr, etcz.
Will likely need Blood transfusion.

Treatment may involve surgical procedures or the more conservative medical approach with hormonal regulators.

Hope I did some fair justice.

Thats a wow... You did well. Your diagnosis is on point!

Apart from the routine lab work up? Can you think of any other investigation that could be useful?

Your treatment plan is also good.

lovely one @nairadaddy

Well CT Scan or better still MRI will definitely help.

Case #2 - I'm guessing Lyme disease?
Workup = Elisa test followed by Western Blot
Treatment = course of antibiotics 14-21 days Doxycycline, Amoxicillin or Cefuroxime.

Disclaimer: I am not a doctor and I also don't play one on TV 😉

Lol @tamala we can get to discuss about the case in our discord channel today... You are most welcome to participate and learn.

The near future that all things be done with a cell phone

Lol... Decentralization has come to stay on the blockchain

I think i agree with @drqamranbashir with his diagnosis and management plan for case 2

I also agree with my other colleagues that the post probable diagnosis for case 1 is endometriosis, considering how cyclical the symptoms appear.
My differentials will include ectopic pregnancy, PID, GIT and urinary tract pathology, which are all ruled out by not being cyclical.

@omaqiin endometrosis and brucellosis are in order.

@drqamranbashir has already done justice to the brucellosis case. While the endometrosis management outlined so far is in order.

Your differentials are also on point. Good to read from you @omaqiin

I really don't know what to diagnose here, but I feel for the case 1, its an ectopic pregnancy.

And I would love to add, I really love what I see here, its quite helpful to people of my kind who are in Medical professions(students).

#AirClinic Rocks

@zylad your diagnosis is not in order for the first case. Ectopic pregnancy may be a differential. Please stay tuned for a summary of these cases in our next edition to gain extra knowledge for future practice.

We appreciate your contribution in the case management @zylad

Reading through everyone's imput, I wouldn't agree less with all the DDs and treatment plan given and to also state that I have learnt from these two cases. Thanks #AIR-CLINIC

Ward rounds is always an avenue to learnnew things @thelovejunkie. Glad we could come up with its replica on the blockchain.

Can you give a brief summary of what you learned? 😋