Skip to main content

70 Y/F With DENOVO Hypertension

 THIS IS AN ONLINE E LOG BOOK 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 SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS WITH AN AIM TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUT.    


This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome.


I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment 

plan   


8- NOVEMBER -2023

70 year old female came to opd with complaints of

Swelling of limbs ( left>> right) since 3 years

Generalized body malaise since 3 months


HISTORY OF PRESENTING ILLNESS

Pateint was apparently asymptomatic 3 years ago , then she developed swelling of limbs, Left>>>Right, insidious in onset and gradually till knee, non pitting type, associated with itching.

No h/o pain, skin changes and discharge

Patient also complains of generalized body malaise since 1 month

No relieving and aggrevating factors

No h/o fever, cold, cough, sob

No h/o any other complaints


PAST HISTORY

K/c/o filariasis since 3 years

Not a k/c/o DM,HTN, TB,Asthma,Epilepsy 


PERSONAL HISTORY:

She is Married

She consumes mixed diet 

Sleep is adequate 

Appetite normal

Bowel and bladder movements are regular


MENSTRUAL HISTORY: 


Age at menarche:12 years

Cycle: 30/5 days, Normal flow

Menopause @ 35 years ago.


OBSTETRIC HISTORY:

Age at Marriage:19 years

1st pregnancy: conceived after 1 month of pregnancy,NVD, 

2nd pregnancy: conceived after 6 months of 1st pregnancy NVD.


FAMILY HISTORY:

No similar complaints in family 


GENERAL EXAMINATION:

Patient is conscious, coherent and co-operative,well oriented to time,place and person.

Moderately build and malnourished.

Examination was done in a well lit room.

No Pallor,Pedal edema, Icterus, cyanosis,clubbing,lymphadenopathy


VITALS 

PR- 96 bpm

BP- 180/80 mm Hg

RR- 16 cpm

Temp -100 F

GRBS - 144 mg/dl








SYSTEMIC EXAMINATION



ABDOMEN 

Inspection

Shape - Slightly distention.

Umbilicus - Everted

Equal movements in all the quadrants with respiration.

No visible pulsation,peristalsis, dilated veins and localized swellings.

No scars , sinuses 



Palpation

Soft, non tender


Auscultation

Bowel sounds heard



RESPIRATORY SYSTEM 

Bilateral air entry present



CVS EXAMINATION 

S1 S2 heard, no murmurs




CNS EXAMINATION 

No focal neurological deficits

Higher mental functions normal

Cranial nerves normal

Sensory examination normal sensations

Motor examination normal

Reflexes normal


INVESTIGATIONS










PROVISIONAL DIAGNOSIS

DENOVO HYPERTENSION
K/c/o Filariasis

TREATMENT

Tab. Amlong 5 mg PO OD
Tab. MVT PO OD
Tab.Diethylcarbamazine citrate (DEC) X 4 weeks
BP monitering 2 hrly








Comments

Popular posts from this blog

54 Y/M with vomitings, SOB, fever

THIS IS AN ONLINE E LOG BOOK 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 SERIES OF INPUTS FROM AVAILABLE GLOBAL ONLINE COMMUNITY OF EXPERTS WITH AN AIM TO SOLVE THOSE CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUT.     This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan 26 NOVEMBER 2023 Patient came to causality with complaints of Fever since 5 days SOB since 5 days Vomiting for 3 days The patient was apparently asymptomatic 5 days back then he developed fever, hi...

Evidence based date wise workflow logs

CASE I Patient Name - 52 year old male Diagnosis HYPERTENSION DIABETES MELLITUS TYPE II HYDRONEPHROSIS SECONDARY TO LEFT RENAL CALCULI Case History and Clinical Findings C/O LEFT SIDE LOIN PAIN SINCE 3MONTHS HOPI: PATIENT WAS APPARENTLY ASYPTOMATIC 3MONTHS BACK THEN HE DEVELOPED LOIN PAIN LEFT SIDED WHICH WAS INSIDIOUS IN ONSET GRADUALLY PROGRESSIVE AND RELIVED ON VOIDING URINE NO H/O BURNING MICTURATION,FEVER,COUGH,COLD,SHORTNESS OF BREATHE,LOOSE STOOLS SEZIURES PAST HISTORY K/N/O HYPERTENSION SINCE 10 YEARS AND ON MEDICATION WITH METOPROLOL 25mg 1...0...0 TYPE 2 DM SINCE 10YEARS OM METFORMIN 500MG BD H/O RENAL CALCULI 5YEARS BACKFOR WHICH SURGERY WAS DONE ONCE IN 2016 AND OTHER IN 2019 H/O COVID INFECTION IN 2020, RESOLVED PERSONAL H/O SLEEP ADEQUATE BOWEL AND BLADDER MOVEMENTS REGULAR APPETITE NORMAL NO ALLERGIES GENERAL PHYSICAL EXAMINATION GENERAL EXAMINATION: PATIENT IS C/C/C NO SIGNS OF PALLOR,CYANOSIS,CLUBBING,LYMPHADENOPATHY,EDEMA VITALS: TEMP:AFEBRILE PR:82BPM RR:16 CPM BP: 1...

1801006094 - LONG CASE

 This is an a online e log book to discuss our patient's de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centred online learning portfolio and your valuable inputs on the comment box is welcome. I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment. 3 January 2022 A 55yr old male came with the chief complaints of *Tingling and Burning sensation in left leg and left hand since 15 days *Chest pain since 6days  HISTORY OF PRESENTING ILLNESS Patient was app...