48yr/female with thyroid swelling




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."

DATE:— 17 march 2022


A 48 yr old woman farmer by occupation came to opd with chief complaints of swelling in the neck and weight loss since 2 months.

History of present illness:— 

Patient was apparantly assymptomatic 1yr back , then she devoleped pea sized swelling in the neck gradually progressive to the present size .

C/o swelling in the neck since 1yr

C/o hoarseness of voice since 6 months

C/o difficulty in swallowing since 6 months

H/o weight loss since 2 months.


Past history:— No c/h/o dm , htn,asthma and tb.

                 H/o   Thyroid since 1 year 

Treatment history:— carbimazole (25mcg) since 1 year. Under medication for 7 months and then stopped. Later again after 2 months started to take same medicine.

Personal history:— married 

diet- mixed  

appetite-normal 

sleep- adequate.    

Bowel movements:— diarrhoea 

Bladder movements- normal

Addictions:— none

General examination:— patient is concious ,cohherent and cooperative and well oriented to time place and person.

Pallor-present

No signs of icterus,cyanosis,clubbing and lymphadenopathy.

-Pedal edema extended upto knees.




Vitals:— 
Temp -98.5 F
RR -17 per min
Pulse -128 /min
Bp:- 110/80
Grbs:— 94mg/dl
Po2-99%

Systemic examination:—
CVS-S1s2 heard no murmers
Rs— bae-normal
CNS—NAD

Investigations:—

Thyroid function tests:— (outside report)




ECG 

    USG neck:—  (outside reports)



LFT:— 


FNAC:—  malignancy??

Provisional diagnosis:— toxic adenoma ?

Plan:— conservative management 

Radioactive iodine - destroys thyroid gland slowly.

Surgical:— thyroidectomy (later treat for hypothyroid)





Comments

Post a Comment

Popular posts from this blog

60 yr/F with sudden loss of consciousness.

Image
 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.  25/08/22 60 year old female ,resident of chityala,who is a house wife came with chief complaints of sudden of loss of consciousness On 23/08/22 at 8 pm for 30minutes HOPI: patient was apparently asymptomatic 1 day ago ,then  she developed sudden  loss of consciousness for 30 minutes at around 8 pm in the night,(she felt a bit dizzy in the evening and later went to sleep to have some rest while she was asleep around 8 pm she had this episode of loss of consciousness associated wit
Read more

60 year old female with fever, backache and generalised weakness.

Image
 Jan 3 2023 This is an online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input. This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome. I have 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 diagnosis and treatment plan. 60 year old female was admitted to opd with chief complaints of 1.Fever since 10 Days 2.Backache since 10days 3.Generalised weakness since 10 days History of presenting illness:— Patient was apparen
Read more

57/M with fever and bilateral pedal edema

Image
   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 Date:— 15 march 2022 A 57 year old male patient with bilateral pedal edema 57 year old male farmer by occupation Came with complaints of fever since 3 days. History of present illness:— Patient was apparently asymptomatic 4 months back then he developed:  Bilateral pedal edema, pitting type, insidious in onset, gradually progressive from ankle to below knee H/o dcreased urine output No h/o palpitations or burning micturition or chest pain. C/o B/L knee pain since 4 months Patient
Read more