Prefinal Examination paper 1

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76 year old female with hemiballismus secondary to uncontrolled sugars

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  This is an online e log book to discuss our patient 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 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 . Unit 1 Amc bed 1 DOA 22/5/23 A 66 yr old female ,residence of nalgonda came to the opd with c/o  Slurring of speech since 15days Involuntary movements of right upper limb since 10days And right lower li
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76 Female with hemiballismus secondary to uncontrolled sugars

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 A 66 yr old female ,residence of nalgonda came to the old with c/o  Slurring of speech since 15days Involuntary movements of right upper limb since 10days And right lower limb since 5 days She was apparently asymptomatic 15days ago then she developed swelling of tongue f/b slurring of speech , insidious in onset and gradually progressive,no aggravating and relieving factors Not associated with deviation of mouth  C/o involuntary movements of right upper and lower limb,insidious in onset and gradually progressive , aggravating on increasing sugars and decreasing with decrease in grbs levels She also c/o skin lesions over genital region since 15days Past history: K/c/o HTN since 2 years K/c/o DM since one week  She has h/o joint pains( shoulder and elbow) since 2-3 months for which she went to a local hospital and the reports shower RA FACTOR+  and was advised tab . methotrexate (on regular medication) Personal history: Diet :mixed  Appetite:normal  Bowel and bladder:regular but c/o bu
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Chief complints- A 4yrs old female child Was brought by mother with the complaints of cough :: 7days History of Presenting illness: child was apparently asymptomatic 7days back then developed cough which was Productive type, diurnal variation Present, gradually progressive more during the night time associated with post tussive vomiting. It is associated with nasal discharge noisy breathing, not associated with mouth breathing H/o fever  5 days back for 3 days which was gradual in onset, low grade, intermitta not associated with rigors; aggrevates durine night time , relieved on taking medication Past History  H/o nasal discharge at 3 months of age. Shown to local RMP , where symptomatic and supportive treatment was given and symptoms subsided. No documentation available Antenatal History -conceived spontaneously after 9 months of married life Natal History Full term, LSCS  BT WT 2.5kg cried immediately after birth Breast fed within 24 hours of delivery . POST NATAL HISTORY H/O NiCU
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