My experiences with general cellular and neural cellular pathology in a case based blended learning ecosystem's CBBLE

30th May 2023

A medical student learns best with the help of experienced mentors, supportive peers and the patients that he/she comes across.

I am Sanjana, a medical student from India.

As a part of my curriculum, I had the opportunity to interact with real patients during my clinical rotations and learnt many valuable lessons from them that I could not have learnt from textbooks or lectures. 

Here are some of my experiences, that have pushed me to have a better clinical insight and to develop my skills.

CBBLE PAJR PARTICIPATORY LEARNING ACTION RESEARCH DISCLAIMER

NOTE: THIS IS AN ONLINE E LOGBOOK TO DISCUSS OUR PATIENT'S DE-IDENTIFIED HEALTH DATA SHARED AFTER TAKING HIS/HER GUARDIAN'S SIGNED INFORMED CONSENT. HERE WE DISCUSS OUR INDIVIDUAL PATIENT'S PROBLEMS THROUGH A SERIES OF INPUTS FROM THE AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS INTENDING TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE-BASED INPUT

My first case was a 65 year old female, accompanied by her daughter, who came with a complaint of decreased urine output since 4 days. On further questioning the patient, she said that she wasn't actually passing any urine since a day. 

To me, her problem seemed to be a rather direct one, giving the impression of an acute kidney injury, requiring no further thought.

But on asking her how the symptoms had progressed and how they had occurred, she actually had a history of a surgery for which she took NSAIDS for pain control, that caused her kidney dysfunction. 

A year later, she noticed decreased urine output and on visiting various other hospitals, she was advised dialysis for which she came to KIMS. 

http://sanjanakulakarni140.blogspot.com/2022/10/65-year-old-female-with-decreased-urine.html

For someone who hasn't been able to connect the symptoms of a patient and have a deeper insight into what might be the cause of a particular disease, this came across as a lesson and will be etched into my mind whenever I see any other patient.

Thus the relevant history and examination, as one may think, is never limited to the system that the patient complaints of, and that is something that I've learnt during my postings. 

Another case of a 32 year old male who came with his wife, with the complaint of not passing stools since 2 days, wherein the patient also had history of abdominal pain since many years due to alcohol consumption without taking food.

I couldn't help but notice that his wife was very concerned about his habit of alcohol intake.

This made me realise how one's lifestyle can not only affect them, but their family too. The patient's daily routine had little to no physical activity and he had alcohol every single day.

The patient also had abdominal distension, yellowing of the sclera and on examination he had altered liver function tests, i.e, his ALP levels and his bilirubin levels were high.

Patient also had decreased appetite.

All these were signs of alcohol hepatitis and the patient was advised to abstain from alcohol intake.

http://sanjanakulakarni140.blogspot.com/2023/01/32-year-old-male-with-abdominal-pain.html

My interaction with patients through clinical rounds and case taking has helped me 

-Gain practical experience and skills

- Develop empathy and communication abilities that help build rapport with patients

- Learn under the guidance of experienced mentors

- Facing challenges and recognizing areas of weaknesses for further improvement to provide better quality of life for the patients.