50 YEAR OLS FEMALE WITH MULTIPLE JOINT PAINS
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 CLINICAL PROBLEMS WITH COLLECTIVE CURRENT BEST EVIDENCE BASED INPUT
CHEIF COMPLAINTS:
c/o multiple joint pains since 1 year
C/o Neck pain since 1 month
C/o Diminision of vision in both eyes since 6 months
HOPI:
Patient was apparently asymptomatic 1 year back then she developed pain over the DIP,PIP,MCP, elbow joint,knee joint,ankle joint ,MTP joint
C/o Burning sensation of feet
No c/o SOB , palpitations,chest pain ,orthopnea,PND .
No c/o pain abdomen, fever , burning micturition
PAST HISTORY:
Not a known case of HTN ,type 2 DM, epilepsy, thyroid disorders, asthma, Tb.
PERSONAL HISTORY:
Diet - Mixed
Appatite - Normal
Sleep - Normal
Bowel and Bladder -Regular.
Allergy - None
Addictions -None
FAMILY HISTORY:
No history of similar complaints in the family.
GENERAL EXAMINATION:
The patient is conscious,coherent and cooperative; well oriented to time,place and person.
Pallor - present
Icterus- absent
Clubbing-absent
Cyanosis-absent
Lymphadenopathy-absent
Edema - absent
Vitals at the time of admission:
Temperature - 98.6 F.
Pulse rate - 78/ minute
Respiratory rate - 18/minute
Blood pressure - 100/70 mmHg
SYSTEMIC EXAMINATION:
CVS:
S1 and S2 heard.
No addded thrills or murmurs heard
RESPIRATORY SYSTEM:
Normal vesicular breath sounds heard.
Bilateral air entry present.
ABDOMEN:
non tender
soft
CNS:
Conscious and coherent.
Normal sensory and motor responses.
INVESTIGATIONS:
TREATMENT:
1.Tab.Methotrexate 7.5 mg on Sundays (weekly once)
2.Tab.folic acid 5mg alternate days po/od
3.Tab hcq 400mg po/od.
