25 yr old male with purpurea evaluation

17/08/2022

Eblog2

 Hi, I am shaik karishma , 3rd Sem Medical Student.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 patient's clinical problems with collective current best evidence based inputs. 

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

I've 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 a diagnosis and treatment plan. 

CHIEF COMPLAINTS : 

Painful skin lesions over the fingertips and sole since 4 days

H/o burning sensation over epigastric region since one month

History of present illness:

 Patient was alright 4days back, he had complaints of painful lesions over fingertips and sole and history of burning sensation over epigastric area and in associated with dry cough,headache since on month. He had abdominal tightness and back pain and also his metacarpophalengeal joint were aggrevating on work.

Past history:

Decreased appetite since 4 years and no similar complaints in past 

Negative history: 

No fever 

No diabetes 

No hypertension 

No coronary artery disease

No TB 

No asthma 

Used antibiotics 

No chemo/radiation 

Personal history: 

Loss of appetite

Regular bowels 

Normal micturition

No ALLERGIES

family history:

No diabetes 

No hypertension

No stroke 

No TB 

No asthma

No cancer

GENERAL EXAMINATION

No pallor 

No icterus 

No cyanosis 

No clubbing of fingers 

No lymphadenopathy

No oedema

No malnutrition 

No dehydration 

VITALS

Pulse: 95bpm

BP : 100/80 mmhg

SYSTEMIC EXAMINATION 

CVS

no thrills 

Cardiac sounds S1 S2 present

Cardiac murmurs absent

RESPITORY SYSTEM

no dyspnoea

No wheezing

Centrally placed trachea

Vesicular breathe sounds 

ABDOMEN

scaphoid shape 

Tenderness present

No palpable mass 

Hernial orifices are normal

Free fluid absent

Liver and spleen were not palpable 

Bowel sounds present

Genitals normal

CNS

conscious

Normal speech 

No neck stiffness

Cranial nerves normal

Motor system normal

Sensory system normal

Reflexes are present in triceps,biceps,supinator and knee 

Ankle reflexes are absent 

Cerebellar signs:

 fingernose coordination absent

INVESTIGATIONS









Medication : atarax 25mg
Pantop 40 mg
Dolo 650
Ultracet
Hydrocortisone injection


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