GM case 6

G m case 6
August 2 ,2023

Case scenario 
My self k.priyanka 3rd year bds student.This is an online e blog to discuss our patient health data shared after taking her guardian sign informed consent . here we discuss individual patient problem through series of inputs from available global online community  of experts with aim to solve patient problem  with collecting current best evidence based inputs.

Chief compliant

A male patient of 80 yrs  is admitted to hospital because of shortness of breath and continues hiccoups during sitting and lying position from one week.

History of present illness

Patient was apparently asymptomatic 1 week back and suddenly developed short Ness of breath and continues hiccoups during sitting and lying position
Onset is sudden
Duration 1 week
Aggrevating during lying position hiccoups are continuous.
Shortness of breath relieving on taking medication but hiccoups are continuous even after taking medication.
It belongs to grade 1 breath less Ness.
Hiccoups are persistent type longer than 48 hours.

History of past illness

Patient was paralysis of one hand and one leg from 3 yrs.it is hemiplagia.
Hypertensive from 10 year 
Diabetic from 10 year 
Not a non case of tb, epilepsy, thyroid issues

Personal history

Diet mixed
Apatite decreased
Sleep decreased
Bowel and bladder normal
No addiction
No allergies to drugs

Family history
No similar compliants

General examination
Patient is conscious and cooperative
Well built and moderately nourished
Pallor no
Icterus no
Clubbing no
Cyanosis no
Lymphedenopathy no
Edema no

Medication 
Metformin
Amlodipine

Vitals 
Temp afebrile
Bp 110/80
Resp rate 14 cycles /min
Pulse rate 64 bpm

Systemic examination 

Inspection

Upper respiratory tract 
Oral hygiene good 
No dental caries
No haltosis
No nasal septum deviation
No sinus tenderness 
No tonsills

Lower respiratory tract
Chest symmetrical 
No drooping of shoulders
Trachea midline 
No supraclavicular and infra clavicular hallowing
No pectus carinatum
No pectus excavam
No kphyoscoliosis

Palpation
Inspectory findings are confirmed 
Superficial
No local rise in temperature 
Trachea midline 
No drooping of shoulders 
No crowding of ribs
 No dilated veins
Chest movement equal
Transverse 50
Anterio posterior 30 
Thoracic circumference 80
Semi thoracic 40

Percussion
Suprascapular and infrascapular
Mamillary
Axillary and infra axillary
Suprascapular and infrascapular
All resonate sounds heared

Auscultation
Normal vesicular breath sounds heared 12 / min

Provisional diagnosis 
Chronic kidney disease




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