GM Clinical case

This is an online E log book to discuss our patient's de-identificatied health data shared after taking his signed informed consent.  SHORT CASE: 1601006099  A 35-year old gentleman who is a farmer by occupation, resident of Miryalaguda,  came to the hospital with:  Chief complaints of swelling in both the legs since 13 months. History of presenting illness: Patient was apparently asymptomatic 3 years back when he was incidentally diagnosed with raised blood pressure of 200/110mm Hg for which he was put on medication which he took for 4 months but wasn’t compliant and thereafter completely stopped taking them.  Patient started developing bilateral pedal edema since 13 months, insidious in onset, pitting type, extending up until the knee, associated with mild facial puffiness and decreased urine output since one year for which he came to the hospital and was put on maintainence hemodialysis for 10 months now. Patient complains of abdominal distension and swell...

This is an online E log book to discuss our patient's de-identificatied health data shared after taking her signed informed consent.  LONG CASE: 1601006099  A 65 yr old female, resident of narketpally, a house wife, came to the hospital with Chief complaints of - Fever with chills since 8 days.  - Pain abdomen and loose stools since 6 days. HISTORY OF PRESENT ILLNESS: The patient was apparently asymptomatic 8 days back, then she developed - Fever, which was sudden in onset, low grade, associated with chills and rigors and relieved on medication. - Pain in abdomen 6 days ago, sudden in onset, continuous, cramping/dull aching type, involving all quadrants and aggravated with food intake. - Associated with 2-3 episodes/day of vomiting which was non bilious, non projectile and watery in consistency. - Multiple episodes of loose stools 6 days back, which was watery and in large volume, no tenesmus, no mucous or blood in stools. - History of burning micturition since 4 days, n...

I have been given this case to solve, in an attempt to understand the concept of "patient clinical data analysis" to progress my competency in reading and comprehending clinical data including history, clinical findings, investigations and to come up with a diagnosis and treatment plan. You can find the entire real patient clinical problem in this link below: https://classworkdecjan.blogspot.com/2019/05/42-f-with-severe-regular-edema-with_17.html?m=1 Following is my analysis of the patient's problem: The problems in order of priority i found are: Headaches Swelling Left side weakness Sleep deprivation Fatigue And the reason for the problem: 1. HEADACHES - Onset of severe headaches at the age of 2. - Became worse with menses at age 14. - Over time, attacks increased in severity. - They are preceded by aura ( mainly visual ) MIGRAINE - Migraine headache is episodic and 20% are classical - associated with aura. Diagnostic Criteria for Migraine [1]      A. At least ...