Gm case 3

Gm case 3 
 Case scenario.....
Hi, this is S.Supriya , IIIrd BDS. This is an online eblog book discuss our patients health data after taking her consent.This also reflects my patient centered online learning portfolio.
 CASE SHEET: 70 years old female joined with slurring of speech since yesterday 
Generalised body pain since 1 day 
Difficult in walking since 1 day 
Patient was apparently asymptomatic 4 years back then delveoped  slurring of speech and diminish of vision and altered and came to hospital and MRI brain was done 
History of present illness : 
Patient with slurring of speech and generalised body pains since 1 day and difficult in walking since 1 day 
No history of memory loss,  seizure 
No history of  fever , vomiting 
No history of smell, deviation of mouth 
History of past illness : 
No  hearing loss , no deviation of tongue 
No history of excessive sweating 
No deviation of tongue 
No history of excessive sweating 
No history Bowel and bladder movement 
Drug history : 
Hypertension since 10 years ( tablets nicardia 20 mg ) 
Dm2 :since years ( mixtard insulin ) 
 Pesonal history : 
Appetite: good 
Diet : mixed 
Bowel and bladder movement : regular 
Micturation : regular 
Allergic: nill 
Sleep adequatence
Family history : 
No such  significant compliance 
General examination: 
Pallor: slightly present 
Cynasis :no 
Clubbing: no
Lymphedenopathy : no 
Edema: no 
Vitals : 
Temperature: 96.3°f 
Bp : 110/70
Spo2: 97%
Systemic examination: 
Cardiac vascular examination : 
Cardiac sounds : s1 ,s2 heard 
Cardiac murmurs: no  
Question from patients: 
How long it take  to cure the problem?
What is the problem for slurring of speech ? Why it is repeated after 4 years ? 

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