35F ?allergic dermatitis METHOTREXATE TOXICITY

This is an online Elog book to discuss our patient deidentified health data shared after taking his/ her guardians sign informed consent

Here we discuss our individual patient problems through series of inputs from available Global online community of experts with n aim to solve those patient clinical problem with collect current best evidence based input

This Elog also reflects my patient centered online learning portfolio.

I have been given this case to solve in an attempt to understand the topic of " Patient clinical data analysis" to develop my competancy in reading and comprehending clinical data including history, clinical finding, investigations and come up with a diagnosis and treatment plan

35 year old female, farmer by occupation resident of aakaram. wakes up at 5 am does household chores till 9am goes to farm and comes back by evening 5pm, cooks food, have dinner and go to bed by 9pm.

The patient is apparently asymptomatic until 5 days ago then she had sudden onset of low grade fever without chills at night time . Not associated with sweating, dizziness, fatigue and body pains.

Second day after onset of fever she went to farm for work and injured her left toe with ?sand while spraying fertilizers. From third day she noticed progressive painful lesions appearing on both lower limbs and upper limbs chest and neck associated with local rise in temperature and swelling . Not associated with loss of sensation, itching, joint pains.

No complaints of headache, burning micturition, giddiness, chest pain, shortness of breath, palpitations, cough ,insomnia, loose stools, loss of appetite.

History of usage of semecarpus anacardium for one day. Tab deflazocort 6mg for five days itraconazole tofloxacin, orividazole, clobetalol propionate, and megaheal ointment for five days

History of psoriasis vulgaris? From 2 years for which she used tab methotrexate 7.5mg OD for one month and capsule itraconazole 100mg OD for one month which she stopped 15 days back

Day 1

Comments

MEDIASTINAL SHIFT USING 2D ECHO PROBE

Case history 40 year male autodriver by occupation resident of Narketpally came to General medicine opd with complains of Pain abdomen since 3 days, Cough since three days and Difficulty breathing since 3 days Patient is apparently alright until 3 days ago then had complains of Epigastric pain and abdominal bloating sensation , insidious onset, intermittent , No aggravating and relieving factors. Patient consumed soda water, eno, jeera soda to alleviate symptoms Complains of Non productive cough insidious onset associated with shortness of breath progressive from grade 1 to grade 4 aggreviated on supine position and lying on right side. History of low grade fever not associated with chills and rigor, no diurnal variations relieved with Tab PCM650 mg No complains of loss of appetite, weight loss, insomnia No complains of Orthopnea, PND, Palpitations, profuse sweating No complaints of burning micturition, increased or decreased urine output No complains of nausea, vomiti...

74M CHF HTN DM PROSTATE CA

74 male from jalalpuram came with complaints of sob and chest pain since 3 days Patient was born and brought up in jalalpuram,lived along with parents and 3 siblings,studies till 9th standard,no health issues in childhood, discontinued education and entered carpenter work at 16 yrs of age. He got married at age of 21 years and had 3 sons and 1 daughter and lead a relatively healthy life, Patient remained asymptomatic till 14 years ago then he developed tingling sensation and weakness of limbs intermittently for which he went to local hospital and was diagnosed of having high blood pressures around 200/100 and was started on anti hypertensives,he was continuing medication and his bp was under control and remained asymptomatics until 7 yrs ago, At that time he had h/o burning micturition along with pain and dribbling of urine ,he went to local hospital for that and was diagnosed of having prostatic carcinoma and resection of tumor was done at that time and also used medicatio...

48F MND HTN DM CVA

48 year female born and bought up in thopicherla to a family of 6 members including four siblings , mother and father. achieved normal milestones. Childhood was pleasant. Father used to do pottery. When I asked how much is the income of her father and that people only buy mud pots only during summer, how would family earn money in other seasons- patient answered that summer is a great business deal for us, but there are many other occasions like temple room,weddings, funerals etc where people use mud pots . Her teacher is a male and alcoholic who used to beat kids, in fear of that she stopped going to school. At age 9 patient had pain abdomen which was diagnosed as appendicitis and underwent appendectomy She lost her father 15 years ago due to old age. Mother is now older than 100 years bedridden stays at her elder sister home Later she lost her elder brother due to cancer at Osmania General hospital At age 18 patient attained menarche, in the same year she was marrie...

Himaja

Search This Blog