A case discussion of a 42year female patient with mutliple health conditions

Presented by- K.Raaga Meghana

Roll No-73 8th semester

                           I've been given the 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.

You can find the entire real patient clinical problem in this link-

https://classworkdecjan.blogspot.com/2019/05/42-f-with-severe-regular-edema-with_17.html?m=1

Following is the analysis of the patients problems in my order of priority-

1-Migraine with aura

2-Swelling of face and abdomen

3-sleeplessness 

4- fatigue

5- increase tolerance to pain

6-oliguria

Details of the complaints-

Migraine with aura-

•onset- sudden 
•duration-40 years 
•progression- gradually progressive 
•site- more to the left
•associated complains-
  1- aura
  2-numbness of left hand and left side of face

Past history-
-At 34 years of age, she had a massive headache which caused loss is vision and shuttering.
-CSF rhinorrhoea from left nostril
-mild memory loss

 Differential diagnosis-
-Brain tumours
- meningitis and other infections
-seizures

Investigations required-
-CT brain
-MRI brain
-CSF analysis 
-EEG

Treatment-
-migraine-triptans
-seizures-anti epileptics

Swelling of face and abdomen-

•onset-since 1 year of age
•duration- 40 years

•Associated factors - Shortness of breath, Decreased urination(increased on fasting), Dark coloured urine on exercise

Differential diagnoses : 

• Angioedema 

Investigations done in this case are :

• Hemogram 
• ECG 
• SGPT, SGOT

Treatment-

• avoid stress
• Serine- increased urination
• Excess salt consumption

Sleeplessness -

• Onset - since birth
• Duration of sleep - 2-4 hours 

Treatment -

• L serine 
• Cimetidine      

Fatigue-

•mostly due to severe exercising 

Treatment-

•Ribose