Learning aspects during my internship

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This is mamatha , currently posted in the department of medicine , here I share few of my learning   experiences


I am sincerely grateful to the Department of Medicine for imparting a wealth of knowledge and skills during my time of study. 

My journey in the Medicine Department has been transformative, equipping me with valuable insights, skills, and a deepened understanding of the medical field. 

I extend my heartfelt gratitude to the Head of the Postgraduate Department and PG's and my seniors  for their unwavering support and guidance, which has played a pivotal role in my learning and professional growth. 

I have posted in the department of medicine from September 2023 to November 2023 and here are the key learnings I've gained during my posting. 

Case 1 A 33 year old female with hematemesis, iron deficiency anemia 


I  saw endoscopy procedure being done for the patient 

I came to  what are the indications required for doing endoscopy, preparation of the patient 

I saw procedures like diagnostic nasal endoscopy and vls procedure 












Case 2 : 




During psychiatry postings 

I have seen different cases like 

Paranoid schizophrenia 

Acute stress reaction 

Generalised anxiety disorder 

Alcohol dependence syndrome 

DAC centre cases 

Somatisation disorder 

Panic disorder cases 

During the time of our psychiatry posting 

We participated in the world mental health day , spreading awareness about the different superstitions  and myths  we face in our socitey regarding the psychiatric illness 

During nephrology posting 

I came to know about dialysis 

Dialysis types 

Peritoneal dialysis 

Maintenance hemodialysis

ACUTE INTERMITTENT HEMODIALYSIS

CONTINUOUS HEMODIALYSIS+ ULTRAFILTRATION 

CAPD

CCPD

NIPD 

I

Indications for hemodialysis:

Acidosis - metabolic acidosis 
Electric abnormality refractory hyperkalemia ,hypercalcaemia 
Intoxication  barbiturates, alcohol , lithium 
Overload - hypervolemia
Uremic encephalopathy, pericarditis , asterixis, seizures . 

Complications during dialysis: 
Intradialytic hypotension: 
Due to volume changes 
           Cardiac factors 
         Lack of vasoconstriction 
Muscle cramps 
Dialysis dysequilibrium syndrome 


Dialysis dysequilibrium syndrome : 

Cerebral edema due to rapid removal of all the urea 
Sudden shift in osmolarity 
Water moves from blood to cerebral space . 

Reactions associated with dialysis: 

Type A reaction 

Ig E mediated immediate hypersensitivity reaction in response to Eto 
Occur within minutes
Stop dialysis and give s.c adrenaline 

Type B reaction 
Delayed d/t complement activation 
Occurs after hrs 
Continue hemodialysis.


 Came to know about the dialysate used  

M.c used bicarbonate buffer 

Reprocessors used  are glutarldehyde/formaldehyde/peracetic acid 

Usual blood flow rate for dialysis 

 UFR  calculation 


UF rate (milliliters per hour per kilogram) =

 predialysis  weight  − postdialysis weight

 [milliliters])/delivered TT (hours)/postdialysis weight (kilograms).

Bfr in dialysis: 300- 500 ml/min

Dialysis flow rate :500- 800 ml/min 

I assisted. Post graduates during my nephrology posting

In procedure like central line placing for HD , ASCITIC 

Tapping 

I have done aseptic foleys catherization 

Taken abg samples 

Ryles tube catherization


During icu postings I did monitoring for patients checking their vitals , grbs monitoring ,  adjusting infusion drip 

Did cpr to revive the patient 

Did foleys catherization 

Taken ABG samples 

Placed i.v cannula 




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