THYROID SWELLING-JAGADISH.pptx
•Download as PPTX, PDF•
0 likes•33 views
A 30-year-old woman presented with a gradually enlarging neck swelling over the past 6 years. On examination, a 6x8cm firm, mobile nodule was found in the front of the neck that moves with swallowing. She has no symptoms of hypo- or hyperthyroidism. Based on the examination, the probable diagnosis is a benign solitary thyroid nodule.
Report
Share
Report
Share
Recommended
Thyroid.pptx
A 50-year-old female presented with a swelling in the front of her neck for 4 years. On examination, a 6x4 cm firm, nodular swelling was found in the front of her neck in the thyroid region. She reports no symptoms of pressure, hyperthyroidism, hypothyroidism, or malignancy. Based on her history and examination, she appears to have a case of nontoxic, nonmalignant multinodular goiter.
Thyroid Swelling: A practical guide on writing and presenting a clinical case
Every book tells us how to examine and what to examine in a clinical case. But, no book tells us exactly how to write a sheet and how to word the case. Here is a practical example ! Hope it helps!
Case presentation gastrology
during my internship in gastroenterology department i presented the case, chairperson was my beloved sir Prof AHM Rowshan. this is a case about a 20 year old female presented with abdominal pain, fever which was low grade, and weight loss with marked anorexia for few months. the diagnosis was a dilemma. patient was undergone laparoscopic biopsy from intrabdominal enlarged lymph nodes and ultimately the diagnosis was a case of Non-Hodgkin's lymphoma and treated by chemotherapy.
Lymphoma case presentation : Neck mass. History taking proforma.
A 18-year old female student presented with a 6 month history of a painless swelling on the left side of her neck and fever for the past 4 months. On examination, a 4x3 cm firm, rubbery and mobile lymph node was palpated in the left neck from level II to III. No other lymph nodes were palpated. The patient also reported unexplained weight loss. All other systems were normal on examination.
5. PDA
KA, a 7-month-old Malay boy, was admitted to the hospital due to shortness of breath, coughing, and vomiting. On examination, he showed signs of respiratory distress including rapid breathing and recession of the ribs. Auscultation revealed widespread crackles and wheezes throughout both lungs. A provisional diagnosis of pneumonia was made, with bronchiolitis and asthma considered as differentials. Blood tests and renal function were normal.
lump in abdomen (2).pptx
A 70-year-old female presented with a painless lump in her left upper abdomen that had been gradually increasing in size over the past 2 months. On examination, a 15x14 cm oval-shaped lump was found in the left hypochondriac region extending to the umbilicus. The lump was firm, had smooth margins, and moved with respiration but was not ballotable. Percussion over the lump revealed a dull sound. Based on the examination, the doctor's provisional diagnosis was splenomegaly in the 70-year-old female.
4. Ischemic Heart Disease with Hypertension-Dr.Fatema.pptx
A 74-year-old man presented with abdominal pain, nausea, vomiting and fever for 2 days. He has a history of hypertension and ischemic heart disease treated with medications. On examination, he had tenderness in the right lower quadrant. Tests showed elevated white blood cell count and ultrasound revealed inflamed appendix with fluid in the right lower quadrant. The provisional diagnosis was acute appendicitis requiring an emergency open appendicectomy.
Thyroid case discussion
A 45-year-old woman presented with a 2-year history of a swelling on the left side of her neck and 3 months of pain in the swelling. On examination, a 4x5cm irregular, firm, nodular swelling was found on the left side of her neck. Differential diagnoses included solitary nodular goiter, follicular adenoma/carcinoma, and chronic lymphocytic thyroiditis. Tests showed a nontoxic nodular goiter. She underwent a left lobectomy and isthumectomy, with tissue sent for histopathology.
Recommended
Thyroid.pptx
A 50-year-old female presented with a swelling in the front of her neck for 4 years. On examination, a 6x4 cm firm, nodular swelling was found in the front of her neck in the thyroid region. She reports no symptoms of pressure, hyperthyroidism, hypothyroidism, or malignancy. Based on her history and examination, she appears to have a case of nontoxic, nonmalignant multinodular goiter.
Thyroid Swelling: A practical guide on writing and presenting a clinical case
Every book tells us how to examine and what to examine in a clinical case. But, no book tells us exactly how to write a sheet and how to word the case. Here is a practical example ! Hope it helps!
Case presentation gastrology
during my internship in gastroenterology department i presented the case, chairperson was my beloved sir Prof AHM Rowshan. this is a case about a 20 year old female presented with abdominal pain, fever which was low grade, and weight loss with marked anorexia for few months. the diagnosis was a dilemma. patient was undergone laparoscopic biopsy from intrabdominal enlarged lymph nodes and ultimately the diagnosis was a case of Non-Hodgkin's lymphoma and treated by chemotherapy.
Lymphoma case presentation : Neck mass. History taking proforma.
A 18-year old female student presented with a 6 month history of a painless swelling on the left side of her neck and fever for the past 4 months. On examination, a 4x3 cm firm, rubbery and mobile lymph node was palpated in the left neck from level II to III. No other lymph nodes were palpated. The patient also reported unexplained weight loss. All other systems were normal on examination.
5. PDA
KA, a 7-month-old Malay boy, was admitted to the hospital due to shortness of breath, coughing, and vomiting. On examination, he showed signs of respiratory distress including rapid breathing and recession of the ribs. Auscultation revealed widespread crackles and wheezes throughout both lungs. A provisional diagnosis of pneumonia was made, with bronchiolitis and asthma considered as differentials. Blood tests and renal function were normal.
lump in abdomen (2).pptx
A 70-year-old female presented with a painless lump in her left upper abdomen that had been gradually increasing in size over the past 2 months. On examination, a 15x14 cm oval-shaped lump was found in the left hypochondriac region extending to the umbilicus. The lump was firm, had smooth margins, and moved with respiration but was not ballotable. Percussion over the lump revealed a dull sound. Based on the examination, the doctor's provisional diagnosis was splenomegaly in the 70-year-old female.
4. Ischemic Heart Disease with Hypertension-Dr.Fatema.pptx
A 74-year-old man presented with abdominal pain, nausea, vomiting and fever for 2 days. He has a history of hypertension and ischemic heart disease treated with medications. On examination, he had tenderness in the right lower quadrant. Tests showed elevated white blood cell count and ultrasound revealed inflamed appendix with fluid in the right lower quadrant. The provisional diagnosis was acute appendicitis requiring an emergency open appendicectomy.
Thyroid case discussion
A 45-year-old woman presented with a 2-year history of a swelling on the left side of her neck and 3 months of pain in the swelling. On examination, a 4x5cm irregular, firm, nodular swelling was found on the left side of her neck. Differential diagnoses included solitary nodular goiter, follicular adenoma/carcinoma, and chronic lymphocytic thyroiditis. Tests showed a nontoxic nodular goiter. She underwent a left lobectomy and isthumectomy, with tissue sent for histopathology.
Physical diagnosis
The 85-year-old male patient presented with progressive forgetfulness, weight loss, and depressed mood over the past year since his wife's death. His daughter observed a decline in his ability to recall recent events, directions, and names. Alzheimer's disease is the primary consideration given his age and symptoms consistent with typical memory loss and cognitive decline seen in Alzheimer's. Differential diagnoses considered include delirium, depression, and hypothyroidism but were deemed less likely based on aspects of his history and presentation that did not fully match these conditions.
History and PE
The 85-year-old male patient presented with progressive forgetfulness, weight loss, and depressed mood over the past year since his wife's death. His daughter observed deterioration in his memory, concentration, and ability to carry on conversations. Alzheimer's disease is the primary consideration given his age and symptom progression. Differential diagnoses considered include delirium, depression, and hypothyroidism but were deemed less likely based on aspects of his clinical presentation and history.
Ibd by dr qasim
This patient presented with a 6 month history of rectal bleeding, loose stools for 2 months, abdominal pain for 20 days, and weight loss of 21 kg over 2 months. A physical exam revealed pallor, abdominal tenderness, oral thrush, and scrotal rash. The differential diagnoses included inflammatory bowel disease, intestinal TB, infective enterocolitis, and malignancy.
mustafe shafie.docx
This document summarizes the case report of a 45-year-old male patient presenting with a 1-month history of cough. On examination, the patient appeared weak and malnourished with tachycardia, tachypnea, dullness on left lung percussion, and decreased breath sounds on the left side. The differential diagnosis included pulmonary tuberculosis, pneumonia, bronchiectasis, and lung cancer. The final diagnosis was pulmonary tuberculosis with acute community-acquired pneumonia based on symptoms, physical exam findings, and need for further diagnostic workup.
HYPERTENSIVE DISORDERS OF PREGNANCY.pptx
This document summarizes a case study of a 36-year-old pregnant woman in her third trimester who presented with high blood pressure readings. She has no other symptoms. Her medical history includes one previous cesarean delivery due to high blood pressure during that pregnancy. On examination, she is found to have a blood pressure of 160/110 mm Hg, grade 2 pedal edema, and urine albumin of ++. The provisional diagnosis is preeclampsia with severe features at 32 weeks and 5 days gestation.
SOAP NOTE SAMPLE FORMAT FOR MRCName LPDateTime 1315.docx
SOAP NOTE SAMPLE FORMAT FOR MRC
Name: LP
Date:
Time: 1315
Age: 30
Sex: F
SUBJECTIVE
CC:
“I am having vaginal itching and pain in my lower abdomen.”
HPI:
Pt is a 30y/o AA female, who is a new patient that has recently moved to Miami. She seeks treatment today after unsuccessful self-treatment of vaginal itching, burning upon urination, and lower abdominal pain. She is concerned for the presence of a vaginal or bladder infection, or an STD. Pt denies fever. She reports the itching and burning with urination has been present for 3 weeks, and the abdominal pain has been intermittent since months ago. Pt has tried OTC products for the itching, including Monistat and Vagisil. She denies any other urinary symptoms, including urgency or frequency. She describes the abdominal pain as either sharp or dull. The pain level goes as high as 8 out of 10 at times. 200mg of PO Advil PRN reduces the pain to a 7/10. Pt denies any aggravating factors for the pain. Pt reports that she did start her menstrual cycle this morning, but denies any other discharge other that light bleeding beginning today. Pt denies douching or the use of any vaginal irritants. She reports that she is in a stable sexual relationship, and denies any new sexual partners in the last 90 days. She denies any recent or historic known exposure to STDs. She reports the use of condoms with every coital experience, as well as this being her only form of contraceptive. She reports normal monthly menstrual cycles that last 3-4 days. She reports dysmenorrhea, which she also takes Advil for. She reports her last PAP smear was in 7/2016, was normal, and reports never having an abnormal PAP smear result. Pt denies any hx of pregnancies. Other medical hx includes GERD. She reports that she has an Rx for Protonix, but she does not take it every day. Her family hx includes the presence of DM and HTN.
Current Medications:
Protonix 40mg PO Daily for GERD
MTV OTC PO Daily
Advil 200mg OTC PO PRN for pain
PMHx:
Allergies:
NKA & NKDA
Medication Intolerances:
Denies
Chronic Illnesses/Major traumas
GERD
Hospitalizations/Surgeries
Denies
Family History
Father- DM & HTN; Mother- HTN; Older sister- DM & HTN; Maternal and paternal grandparents without known medical issues; 1 brother and 3 other sisters without known medical issues; No children.
Social History
Lives alone. Currently in a stable sexual relationship with one man. Works for DEFACS. Reports occasional alcohol use, but denies tobacco or illicit drug use.
ROS
General
Denies weight change, fatigue, fever, night sweats
Cardiovascular
Denies chest pain and edema. Reports rare palpitations that are relieved by drinking water
Skin
Denies any wounds, rashes, bruising, bleeding or skin discolorations, any changes in lesions
Respiratory
Denies cough. Reports dyspnea that accompanies the rare palpitations and is also relieved by drinking water
Eyes
Denies corrective lenses, blurring, visual changes of an.
Clinical meeting on Lobar Pneumonia.pptx
A clinical meeting on Lobar Pneumonia. The patient was admitted & treated in Pulmonology Department of BSMMU
Case summary : Pancreatitis
This document summarizes a 28-year-old Indonesian male patient who presented with abdominal pain, fever, and vomiting. On examination, he was found to have jaundice and tenderness in his right hypochondrium and epigastrium. Laboratory tests showed elevated liver enzymes and bilirubin. Ultrasound revealed gallbladder sludge and dilation of the bile ducts due to a large stone. ERCP confirmed choledocholithiasis with multiple stones in the common bile duct. The provisional diagnoses were ascending cholangitis and cholecystitis.
Acute Leukemia
Md. Huzaifa, a 6-year-old boy, presented with 2 months of fever, multiple nodular swellings, left testicular swelling, and gradual pallor. On examination, he had generalized lymphadenopathy, hepatosplenomegaly, proptosis, and left testicular swelling. Blood tests found pancytopenia and 80% blasts. Bone marrow biopsy revealed 80% lymphoblasts. He was diagnosed with acute lymphoblastic leukemia (B-cell lineage). He received supportive care and chemotherapy. Follow up showed improvement with chemotherapy continuation planned.
lung abscess.pptx
Sree Hari is a 52-year-old manual laborer who presents with a 1-year history of cough with green sputum production, 3 months of worsening breathlessness, and 3 weeks of fever. He has a history of smoking 1 pack of cigarettes per day for 35 years and has been hospitalized 3 times in the last 6 months for cough and breathlessness. On examination, he has clubbing, decreased breath sounds and coarse crackles in the right lung field, and bronchial breath sounds in the right interscapular area, suggestive of pulmonary pathology.
8. all
Rose KhadeejaTihanie, a 3-year-old girl, was admitted with fever, diarrhea, and vomiting. Her history included joint pain and swelling diagnosed as juvenile idiopathic arthritis. On examination, she had hepatomegaly but otherwise normal findings. Testing showed pancytopenia, and bone marrow aspiration found over 90% blasts, consistent with acute lymphoblastic leukemia. Her final diagnosis was juvenile arthritis secondary to acute lymphoblastic leukemia.
8. Acute Lymphoblastic Leukemia
Rose KhadeejaTihanie, a 2 year 11 month old girl, was admitted with fever, diarrhea and vomiting. Examination found hepatomegaly but was otherwise normal. Investigations showed pancytopenia. Bone marrow aspiration found over 90% blasts consistent with acute lymphoblastic leukemia. She was diagnosed with juvenile arthritis secondary to ALL. ALL has a peak incidence in young children and risks include genetic and environmental factors. Clinical features include infections, pallor and organomegaly. Management aims to induce remission through chemotherapy while preventing complications like infections. Prognosis depends on factors like age and white cell count.
Atrial septal defect- Case presentation by Mrunalini Patil
Atrial septal defect- Case Presentation by Mrunalini Patil
Acyanotic congenital heart disease
Cardiovascular system
Case Presentation: Thyroid Swelling
Case presentation of Thyroid Swelling detailing history taking and examination in long case pattern in General Surgery
Hemolytic anemia by dr maaz seerat
This document presents the case of a 20-year-old female student who was admitted to the hospital with a 6-month history of progressive weakness and shortness of breath, as well as fever, body aches, and vomiting for the past week. On examination, she was found to be pale and spleen was palpable. Differential diagnoses included various types of anemias, portal hypertension, leukemias, and lymphomas. Further investigations including Coomb's test and hemoglobin electrophoresis were planned to determine the cause of anemia, and initial treatment included blood transfusion and corticosteroids.
Case presentation.pptx
A 14-year-old boy presented with difficulty breathing, facial swelling, swelling of both feet, and chest pain for two days. He had a history of a similar episode 8 months prior where he was diagnosed with a heart condition. On examination, he had an irregularly irregular pulse, low blood pressure, visible apex beat, and grade V pansystolic murmurs in the mitral, tricuspid, and pulmonary areas, suggestive of chronic rheumatic heart disease with mitral regurgitation and left ventricular hypertrophy.
Parotid swelling
A 32-year-old woman presented with a 2-year history of a swelling below her right ear. On examination, there was a 4.5x1.5cm swelling in the right parotid region with well-defined margins. The swelling was non-tender, firm, and mobile with normal overlying skin. No lymphadenopathy or other abnormalities were noted. Based on the examination, the doctor's diagnosis was a likely benign parotid tumor given the painless swelling without signs of facial nerve palsy or metastasis.
Morning report of a Bactremia Case
Mr. S, a 74-year-old male with diabetes, hypertension, heart disease, and kidney failure, presented to the emergency room with a fever of 38.6°C for one day and neck pain radiating to his head for five days. Examination was unremarkable. Blood cultures grew methicillin-sensitive Staphylococcus aureus sensitive to cefazolin. A CT scan and MRI of the neck showed abnormalities. The plan is to remove the permacath catheter, perform an echocardiogram, continue IV antibiotics, correct hyperkalemia, and follow up with spine surgery. The diagnosis is bacteremia likely from the intravascular catheter.
Clinical Documentation TemplateStudent Deepak Sharma .docx
Clinical Documentation Template
Student: Deepak Sharma Site: Elgin Medical Ctr
Client’s Initials: MS Age : 64 Gender : Male Date: 04/07/2019
Subjective
Chief Complaint: 64 year old Hispanic male present to the clinic with chest discomfort.
HPI: Mr. JG. is a 64-year old male with a history of HTN and dyslipidemia present to the clinic with chest discomfort for past two month. Patient stated that chest discomfort is in the middle of his chest and it feels like a burning sensation along with tingling. Patient rated his pain 5 out of 10. Patient also stated that mostly happen when I am doing activity like climbing stairs however sometime it does happen when I am just watching TV. Patient denies any episodes of felling dizzy or passing out. Patient denied radiation of the pain to neck or jaw. He took Advil and it is not doing anything. Patient is non-compliance with his cholesterol medication.
ROS: General: has slowly gain weight over last ten years, denies weakness, , fevers, memory changes, nervousness, anxiety,depression, suicide.
Skin: no rash, lumps, sores, itching, dryness, color change, change in hair/nails, bruising or bleeding, excessive sweating, heat or cold intolerance.
Head: Denies headache, head injury, dizziness.
Eyes: no vision change, corrective lenses, pain redness, excessive tearing, double vision, blurred
vision, or blindness.
Ears: no hearing change, tinnitus, infection, discharge.
Nose/Sinus: negative for Rhinohea, No sinus pain or epistaxis.
Throat: No bleeding gums, dentures, sore tongue,dry mouth. Last dental exam 4 months ago.
Neck: No lumps, swollen glands, goiter, pain, or neck stiffness.
Neuro: No syncope, seizures, weakness, paralysis, numbness, tremors, or involuntary
movements.
Pulmonary: Dyspnea with activity, negative hemoptysis, wheezing, pleuritic pain
Neuro: No headache dizziness, focal numbness/weakness, nausea, vomiting.
Peripheral vascular: no claudication, leg cramps, varicose veins, history of blood clots,
abdominal, flank, or back pain. Pain in arms or legs. Intermittent claudication, cold, numbness,
pallor legs. Swelling in calves, legs, or feet. No color change in fingertips or toes in cold weather.
Swelling with redness or tenderness.
MS: no muscle, joint pain, or joint stiffness, positive for chest pain
GI: No changes in appetite, excessive hunger or thirst, jaundice, N/V, dysphagia, heartburn, pain,
belching/flatulence, change in bowel habits, hematochezia, melena, constipation, diarrhea, food
intolerance, indigestion, nausea, vomiting, early fullness, odynophagia.
GU: No suprapubic pain, dysuria, urgency, frequency, hesitancy, decreased stream, polyuria,
nocturia, incontinence, hematuria, kidney, or flank pain, ureteral colic, hemorrhoids.
Past Medical History: Hypertension, dyslipidemia
Surgeries: none
Hospitalizations: None
Allergies:.
SQUMOUS CELL CARCINOMA
A 58-year-old woman presented with a painful, rapidly progressive ulcerative growth in her right gluteal region over the past 4 months. On examination, there was a large 10x8x4cm ulcerative growth with irregular shape, everted edges and margins, and surrounding thickened skin. The growth was fixed to the skin and gluteus maximus muscle. A provisional diagnosis of squamous cell carcinoma was made based on the clinical findings.
ileostomy.pptx dr. atul khare
This document presents a case study of a 30-year-old male farmer with an ileostomy. Two months prior he had undergone an emergency surgery for perforated peritonitis which resulted in the creation of a temporary loop ileostomy. He presented with complaints of redness and itching around the stoma site for the past 2 weeks. On examination, the stoma was found to be well-functioning with normal output and appearance. There was excoriated skin near the proximal opening that was healing with topical ointment. The provisional diagnosis was a temporary diverting loop ileostomy with peristomal excoriation.
More Related Content
Similar to THYROID SWELLING-JAGADISH.pptx
Physical diagnosis
The 85-year-old male patient presented with progressive forgetfulness, weight loss, and depressed mood over the past year since his wife's death. His daughter observed a decline in his ability to recall recent events, directions, and names. Alzheimer's disease is the primary consideration given his age and symptoms consistent with typical memory loss and cognitive decline seen in Alzheimer's. Differential diagnoses considered include delirium, depression, and hypothyroidism but were deemed less likely based on aspects of his history and presentation that did not fully match these conditions.
History and PE
The 85-year-old male patient presented with progressive forgetfulness, weight loss, and depressed mood over the past year since his wife's death. His daughter observed deterioration in his memory, concentration, and ability to carry on conversations. Alzheimer's disease is the primary consideration given his age and symptom progression. Differential diagnoses considered include delirium, depression, and hypothyroidism but were deemed less likely based on aspects of his clinical presentation and history.
Ibd by dr qasim
This patient presented with a 6 month history of rectal bleeding, loose stools for 2 months, abdominal pain for 20 days, and weight loss of 21 kg over 2 months. A physical exam revealed pallor, abdominal tenderness, oral thrush, and scrotal rash. The differential diagnoses included inflammatory bowel disease, intestinal TB, infective enterocolitis, and malignancy.
mustafe shafie.docx
This document summarizes the case report of a 45-year-old male patient presenting with a 1-month history of cough. On examination, the patient appeared weak and malnourished with tachycardia, tachypnea, dullness on left lung percussion, and decreased breath sounds on the left side. The differential diagnosis included pulmonary tuberculosis, pneumonia, bronchiectasis, and lung cancer. The final diagnosis was pulmonary tuberculosis with acute community-acquired pneumonia based on symptoms, physical exam findings, and need for further diagnostic workup.
HYPERTENSIVE DISORDERS OF PREGNANCY.pptx
This document summarizes a case study of a 36-year-old pregnant woman in her third trimester who presented with high blood pressure readings. She has no other symptoms. Her medical history includes one previous cesarean delivery due to high blood pressure during that pregnancy. On examination, she is found to have a blood pressure of 160/110 mm Hg, grade 2 pedal edema, and urine albumin of ++. The provisional diagnosis is preeclampsia with severe features at 32 weeks and 5 days gestation.
SOAP NOTE SAMPLE FORMAT FOR MRCName LPDateTime 1315.docx
SOAP NOTE SAMPLE FORMAT FOR MRC
Name: LP
Date:
Time: 1315
Age: 30
Sex: F
SUBJECTIVE
CC:
“I am having vaginal itching and pain in my lower abdomen.”
HPI:
Pt is a 30y/o AA female, who is a new patient that has recently moved to Miami. She seeks treatment today after unsuccessful self-treatment of vaginal itching, burning upon urination, and lower abdominal pain. She is concerned for the presence of a vaginal or bladder infection, or an STD. Pt denies fever. She reports the itching and burning with urination has been present for 3 weeks, and the abdominal pain has been intermittent since months ago. Pt has tried OTC products for the itching, including Monistat and Vagisil. She denies any other urinary symptoms, including urgency or frequency. She describes the abdominal pain as either sharp or dull. The pain level goes as high as 8 out of 10 at times. 200mg of PO Advil PRN reduces the pain to a 7/10. Pt denies any aggravating factors for the pain. Pt reports that she did start her menstrual cycle this morning, but denies any other discharge other that light bleeding beginning today. Pt denies douching or the use of any vaginal irritants. She reports that she is in a stable sexual relationship, and denies any new sexual partners in the last 90 days. She denies any recent or historic known exposure to STDs. She reports the use of condoms with every coital experience, as well as this being her only form of contraceptive. She reports normal monthly menstrual cycles that last 3-4 days. She reports dysmenorrhea, which she also takes Advil for. She reports her last PAP smear was in 7/2016, was normal, and reports never having an abnormal PAP smear result. Pt denies any hx of pregnancies. Other medical hx includes GERD. She reports that she has an Rx for Protonix, but she does not take it every day. Her family hx includes the presence of DM and HTN.
Current Medications:
Protonix 40mg PO Daily for GERD
MTV OTC PO Daily
Advil 200mg OTC PO PRN for pain
PMHx:
Allergies:
NKA & NKDA
Medication Intolerances:
Denies
Chronic Illnesses/Major traumas
GERD
Hospitalizations/Surgeries
Denies
Family History
Father- DM & HTN; Mother- HTN; Older sister- DM & HTN; Maternal and paternal grandparents without known medical issues; 1 brother and 3 other sisters without known medical issues; No children.
Social History
Lives alone. Currently in a stable sexual relationship with one man. Works for DEFACS. Reports occasional alcohol use, but denies tobacco or illicit drug use.
ROS
General
Denies weight change, fatigue, fever, night sweats
Cardiovascular
Denies chest pain and edema. Reports rare palpitations that are relieved by drinking water
Skin
Denies any wounds, rashes, bruising, bleeding or skin discolorations, any changes in lesions
Respiratory
Denies cough. Reports dyspnea that accompanies the rare palpitations and is also relieved by drinking water
Eyes
Denies corrective lenses, blurring, visual changes of an.
Clinical meeting on Lobar Pneumonia.pptx
A clinical meeting on Lobar Pneumonia. The patient was admitted & treated in Pulmonology Department of BSMMU
Case summary : Pancreatitis
This document summarizes a 28-year-old Indonesian male patient who presented with abdominal pain, fever, and vomiting. On examination, he was found to have jaundice and tenderness in his right hypochondrium and epigastrium. Laboratory tests showed elevated liver enzymes and bilirubin. Ultrasound revealed gallbladder sludge and dilation of the bile ducts due to a large stone. ERCP confirmed choledocholithiasis with multiple stones in the common bile duct. The provisional diagnoses were ascending cholangitis and cholecystitis.
Acute Leukemia
Md. Huzaifa, a 6-year-old boy, presented with 2 months of fever, multiple nodular swellings, left testicular swelling, and gradual pallor. On examination, he had generalized lymphadenopathy, hepatosplenomegaly, proptosis, and left testicular swelling. Blood tests found pancytopenia and 80% blasts. Bone marrow biopsy revealed 80% lymphoblasts. He was diagnosed with acute lymphoblastic leukemia (B-cell lineage). He received supportive care and chemotherapy. Follow up showed improvement with chemotherapy continuation planned.
lung abscess.pptx
Sree Hari is a 52-year-old manual laborer who presents with a 1-year history of cough with green sputum production, 3 months of worsening breathlessness, and 3 weeks of fever. He has a history of smoking 1 pack of cigarettes per day for 35 years and has been hospitalized 3 times in the last 6 months for cough and breathlessness. On examination, he has clubbing, decreased breath sounds and coarse crackles in the right lung field, and bronchial breath sounds in the right interscapular area, suggestive of pulmonary pathology.
8. all
Rose KhadeejaTihanie, a 3-year-old girl, was admitted with fever, diarrhea, and vomiting. Her history included joint pain and swelling diagnosed as juvenile idiopathic arthritis. On examination, she had hepatomegaly but otherwise normal findings. Testing showed pancytopenia, and bone marrow aspiration found over 90% blasts, consistent with acute lymphoblastic leukemia. Her final diagnosis was juvenile arthritis secondary to acute lymphoblastic leukemia.
8. Acute Lymphoblastic Leukemia
Rose KhadeejaTihanie, a 2 year 11 month old girl, was admitted with fever, diarrhea and vomiting. Examination found hepatomegaly but was otherwise normal. Investigations showed pancytopenia. Bone marrow aspiration found over 90% blasts consistent with acute lymphoblastic leukemia. She was diagnosed with juvenile arthritis secondary to ALL. ALL has a peak incidence in young children and risks include genetic and environmental factors. Clinical features include infections, pallor and organomegaly. Management aims to induce remission through chemotherapy while preventing complications like infections. Prognosis depends on factors like age and white cell count.
Atrial septal defect- Case presentation by Mrunalini Patil
Atrial septal defect- Case Presentation by Mrunalini Patil
Acyanotic congenital heart disease
Cardiovascular system
Case Presentation: Thyroid Swelling
Case presentation of Thyroid Swelling detailing history taking and examination in long case pattern in General Surgery
Hemolytic anemia by dr maaz seerat
This document presents the case of a 20-year-old female student who was admitted to the hospital with a 6-month history of progressive weakness and shortness of breath, as well as fever, body aches, and vomiting for the past week. On examination, she was found to be pale and spleen was palpable. Differential diagnoses included various types of anemias, portal hypertension, leukemias, and lymphomas. Further investigations including Coomb's test and hemoglobin electrophoresis were planned to determine the cause of anemia, and initial treatment included blood transfusion and corticosteroids.
Case presentation.pptx
A 14-year-old boy presented with difficulty breathing, facial swelling, swelling of both feet, and chest pain for two days. He had a history of a similar episode 8 months prior where he was diagnosed with a heart condition. On examination, he had an irregularly irregular pulse, low blood pressure, visible apex beat, and grade V pansystolic murmurs in the mitral, tricuspid, and pulmonary areas, suggestive of chronic rheumatic heart disease with mitral regurgitation and left ventricular hypertrophy.
Parotid swelling
A 32-year-old woman presented with a 2-year history of a swelling below her right ear. On examination, there was a 4.5x1.5cm swelling in the right parotid region with well-defined margins. The swelling was non-tender, firm, and mobile with normal overlying skin. No lymphadenopathy or other abnormalities were noted. Based on the examination, the doctor's diagnosis was a likely benign parotid tumor given the painless swelling without signs of facial nerve palsy or metastasis.
Morning report of a Bactremia Case
Mr. S, a 74-year-old male with diabetes, hypertension, heart disease, and kidney failure, presented to the emergency room with a fever of 38.6°C for one day and neck pain radiating to his head for five days. Examination was unremarkable. Blood cultures grew methicillin-sensitive Staphylococcus aureus sensitive to cefazolin. A CT scan and MRI of the neck showed abnormalities. The plan is to remove the permacath catheter, perform an echocardiogram, continue IV antibiotics, correct hyperkalemia, and follow up with spine surgery. The diagnosis is bacteremia likely from the intravascular catheter.
Clinical Documentation TemplateStudent Deepak Sharma .docx
Clinical Documentation Template
Student: Deepak Sharma Site: Elgin Medical Ctr
Client’s Initials: MS Age : 64 Gender : Male Date: 04/07/2019
Subjective
Chief Complaint: 64 year old Hispanic male present to the clinic with chest discomfort.
HPI: Mr. JG. is a 64-year old male with a history of HTN and dyslipidemia present to the clinic with chest discomfort for past two month. Patient stated that chest discomfort is in the middle of his chest and it feels like a burning sensation along with tingling. Patient rated his pain 5 out of 10. Patient also stated that mostly happen when I am doing activity like climbing stairs however sometime it does happen when I am just watching TV. Patient denies any episodes of felling dizzy or passing out. Patient denied radiation of the pain to neck or jaw. He took Advil and it is not doing anything. Patient is non-compliance with his cholesterol medication.
ROS: General: has slowly gain weight over last ten years, denies weakness, , fevers, memory changes, nervousness, anxiety,depression, suicide.
Skin: no rash, lumps, sores, itching, dryness, color change, change in hair/nails, bruising or bleeding, excessive sweating, heat or cold intolerance.
Head: Denies headache, head injury, dizziness.
Eyes: no vision change, corrective lenses, pain redness, excessive tearing, double vision, blurred
vision, or blindness.
Ears: no hearing change, tinnitus, infection, discharge.
Nose/Sinus: negative for Rhinohea, No sinus pain or epistaxis.
Throat: No bleeding gums, dentures, sore tongue,dry mouth. Last dental exam 4 months ago.
Neck: No lumps, swollen glands, goiter, pain, or neck stiffness.
Neuro: No syncope, seizures, weakness, paralysis, numbness, tremors, or involuntary
movements.
Pulmonary: Dyspnea with activity, negative hemoptysis, wheezing, pleuritic pain
Neuro: No headache dizziness, focal numbness/weakness, nausea, vomiting.
Peripheral vascular: no claudication, leg cramps, varicose veins, history of blood clots,
abdominal, flank, or back pain. Pain in arms or legs. Intermittent claudication, cold, numbness,
pallor legs. Swelling in calves, legs, or feet. No color change in fingertips or toes in cold weather.
Swelling with redness or tenderness.
MS: no muscle, joint pain, or joint stiffness, positive for chest pain
GI: No changes in appetite, excessive hunger or thirst, jaundice, N/V, dysphagia, heartburn, pain,
belching/flatulence, change in bowel habits, hematochezia, melena, constipation, diarrhea, food
intolerance, indigestion, nausea, vomiting, early fullness, odynophagia.
GU: No suprapubic pain, dysuria, urgency, frequency, hesitancy, decreased stream, polyuria,
nocturia, incontinence, hematuria, kidney, or flank pain, ureteral colic, hemorrhoids.
Past Medical History: Hypertension, dyslipidemia
Surgeries: none
Hospitalizations: None
Allergies:.
Similar to THYROID SWELLING-JAGADISH.pptx (20)
SOAP NOTE SAMPLE FORMAT FOR MRCName LPDateTime 1315.docx
SOAP NOTE SAMPLE FORMAT FOR MRCName LPDateTime 1315.docx
Atrial septal defect- Case presentation by Mrunalini Patil
Atrial septal defect- Case presentation by Mrunalini Patil
Clinical Documentation TemplateStudent Deepak Sharma .docx
Clinical Documentation TemplateStudent Deepak Sharma .docx
More from Atul Khare
SQUMOUS CELL CARCINOMA
A 58-year-old woman presented with a painful, rapidly progressive ulcerative growth in her right gluteal region over the past 4 months. On examination, there was a large 10x8x4cm ulcerative growth with irregular shape, everted edges and margins, and surrounding thickened skin. The growth was fixed to the skin and gluteus maximus muscle. A provisional diagnosis of squamous cell carcinoma was made based on the clinical findings.
ileostomy.pptx dr. atul khare
This document presents a case study of a 30-year-old male farmer with an ileostomy. Two months prior he had undergone an emergency surgery for perforated peritonitis which resulted in the creation of a temporary loop ileostomy. He presented with complaints of redness and itching around the stoma site for the past 2 weeks. On examination, the stoma was found to be well-functioning with normal output and appearance. There was excoriated skin near the proximal opening that was healing with topical ointment. The provisional diagnosis was a temporary diverting loop ileostomy with peristomal excoriation.
Mass per rectum.pptx
Ravikumar, a 35-year-old male farmer, presented with a 1-year history of bleeding per rectum and altered bowel habits for 6 months. On examination, a hard ulceroproliferative growth was felt at 5 cm from the anal verge, involving the whole circumference of the rectum. Proctoscopy revealed an irregular-shaped growth on the anterior rectum without surrounding inflammation. The patient was diagnosed with Dukes stage B carcinoma of the rectum.
meningomyelocoele.pptx
A 1.5 month old female infant presented with a swelling on her lower back since birth. On examination, the swelling was a soft, cystic mass measuring 5x5x4cm over the lumbosacral region, with positive fluctuation and transillumination. A bony gap was felt at the margin of the swelling. Based on these findings, the provisional diagnosis was an unruptured lumbosacral meningomyelocele.
renal cell carcinoma.pptx
A 48-year-old female farmer presented with a painless lump in her left abdomen that had been rapidly increasing in size over the past month. On examination, a large, hard, irregular mass was palpated in the left lumbar region extending to the umbilicus. The mass was non-tender, non-mobile, and dull to percussion. Based on the location and characteristics of the mass, the provisional diagnosis was of a left-sided renal cell carcinoma. No signs of metastasis were found on further examination.
THYROID swelling22.pptx
A 60-year-old woman presented with a swelling in her neck that had grown rapidly over the past 2 months. On examination, she had an irregular, multinodular goiter measuring 18x14 cm that extended from her thyroid cartilage to her suprasternal notch. She reported hoarseness of voice for the past 2 months. The provisional diagnosis was carcinoma of the thyroid with involvement of the recurrent laryngeal nerve, despite her being in an euthyroid state.
portal hypertension.pptx
This document discusses the surgical management of portal hypertension caused by both cirrhotic and non-cirrhotic liver disease. It describes various surgical procedures including shunt surgeries, devascularization surgeries, and splenectomy. Shunt surgeries are the preferred approach as they decompress the portal system and effectively control variceal bleeding and ascites. Distal splenorenal shunt has the best outcomes with selective decompression and lowest risk of encephalopathy. Devascularization surgeries control acute bleeding but do not lower portal pressures and have higher rebleeding rates compared to shunts. Splenectomy may be indicated in specific cases but does not treat the underlying cause of portal hypertension.
subtotal gastrectomy with gastrojejunostomy.pptx
This document outlines a presentation on subtotal gastrectomy with gastrojejunostomy surgery. It discusses the surgical anatomy, indications for the procedure, preoperative evaluation, surgical technique, and potential complications including intraoperative, immediate, early, and late complications. Complications range from hemorrhage and ischemia during surgery to anastomotic leaks, strictures, marginal ulcers, and dumping syndrome in the long term. The document provides an overview of the key aspects of performing and recovering from this type of stomach surgery.
lumbar sympathectomy - Copy.pptx
This document outlines lumbar sympathectomy, a procedure to remove at least one sympathetic ganglion. It discusses the anatomy, indications, contraindications, types of procedures, operative steps, and complications. The key indications for lumbar sympathectomy include hyperhidrosis, causalgia, inoperative arterial occlusive disease causing rest pain or ulceration, and Raynaud's phenomenon. Potential complications include post-sympathectomy neuralgia, retrograde ejaculation, bleeding, and rarely paraplegia or ureteric necrosis. The document provides an overview of this irreversible surgical procedure.
More from Atul Khare (9)
Recently uploaded
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.Best Ayurvedic medicine for Gas and Indigestion
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler, Verified Chapters 1 - 33, Complete Newest Version Community Health Nursing A Canadian Perspective, 5th Edition by Stamler Community Health Nursing A Canadian Perspective, 5th Edition TEST BANK by Stamler Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Study Guide Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Stuvia Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Studocu Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Test Bank For Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Pdf Download Course Hero Community Health Nursing A Canadian Perspective, 5th Edition Answers Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Ebook Download Course hero Community Health Nursing A Canadian Perspective, 5th Edition Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Studocu Community Health Nursing A Canadian Perspective, 5th Edition Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Chapters Download Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Pdf Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Study Guide Questions and Answers Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Ebook Download Stuvia Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Questions Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Studocu Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Quizlet Community Health Nursing A Canadian Perspective, 5th Edition Test Bank Stuvia
Identification and nursing management of congenital malformations .pptx
Identification and nursing management of congenital malformations .pptxMGM SCHOOL/COLLEGE OF NURSING
Identification and nursing management of congenital malformations Cell Therapy Expansion and Challenges in Autoimmune Disease
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Journal Article Review on Rasamanikya
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
STIs may cause PID. For the both disease, herbal medicine Fuyan Pill can be a solution.
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
A Classical Text Review on Basavarajeeyam
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
ABDOMINAL TRAUMA in pediatrics part one.
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
share - Lions, tigers, AI and health misinformation, oh my!.pptx
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Recently uploaded (20)
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptx
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...
Identification and nursing management of congenital malformations .pptx
Identification and nursing management of congenital malformations .pptx
Cell Therapy Expansion and Challenges in Autoimmune Disease
Cell Therapy Expansion and Challenges in Autoimmune Disease
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Hemodialysis: Chapter 4, Dialysate Circuit - Dr.Gawad
Tests for analysis of different pharmaceutical.pptx
Tests for analysis of different pharmaceutical.pptx
Osteoporosis - Definition , Evaluation and Management .pdf
Osteoporosis - Definition , Evaluation and Management .pdf
share - Lions, tigers, AI and health misinformation, oh my!.pptx
share - Lions, tigers, AI and health misinformation, oh my!.pptx
THYROID SWELLING-JAGADISH.pptx
- 1. Solitary Thyroid Nodule DR. JAGADISH N GENERAL SURGERY
- 2. Name- Rajani Jhariya Age – 30years Sex- female Married Religion- Hindu R/O- Jabalpur, MP Housewife
- 3. Chief complaints Swelling in front of the neck since 6years
- 4. History of presenting illness: oPatient was apparently alright 6 years back, when she noticed a swelling in front of the neck which was insidious in onset, initially when she noticed it was about 2cm gradually progressed towards left side of neck to attain present size. oThere is no h/o sudden increase in the size of the swelling oSwelling is not associated with the pain
- 5. oThere is no h/o dyspnoea or dysphagia or hoarseness of voice oNo h/o loss of weight, heat intolerance, sleep disturbance, diplopia, palpitations, dypnoea on exertion oNo h/o weight gain, cold intolerance, loss of hair or constipation oNo h/o cough with haemoptysis, bony pain or convulsions
- 6. Past history Patient consulted elsewhere for the same complaints 5years back where they advised homeopathy medications (documents not available). She stopped taking those medications after 3months on her own Not a k/c/o T2 DM, HTN, PTB, hypo/hyperthyroidism, epilepsy or bronchial asthma No h/o prior irradiation to neck
- 7. Personal history Patient is married Consumes mixed diet Consumes iodised salt Appetite normal Bowel and bladder habits are normal Normal sleep pattern No h/o any drug allergies H/o Gutkha chewing for 10years
- 8. Menstrual history Attained menarche at 13years Cycle is regular with 2-3days of bleeding/28-30days No h/o amenorrhoea, menorrhagia She is P3L3
- 9. Family history No h/o similar complaints amongst the family member No h/o thyroid cancer/ any other malignancy/ unexplained death in the family
- 10. General physical examination Patient is conscious oriented to time, place and person BMI -21kg/m2 No pallor/icterus/cyanosis/clubbing/pedal edema/generalised lymphadenopathy Pulse- 92/min Regular, normal rhythm and volume BP- 114/70mm of hg Measured in right arm in supine position SpO2- 98% on room air
- 11. Head: no alopecia Normal facies Eye: no eye signs, no madarosis Tongue: no tremor Palms: no moist skin, no tremor
- 12. Systemic examination CNS- Patient is conscious oriented to time, place and person CVS- S1 S2+ no murmur heard RS- b/l air entry equal P/A- soft, non tender - no organomegaly - no ascites present
- 13. LOCAL EXAMINATION- NECK In sitting position with adequate exposure of neck and upper chest. 1. INSPECTION:
- 15. There is evidence of single horizontally oval shaped swelling of about 6*8cm over the anterior aspect of neck Vertical extent: lower margin just above the suprasternal notch and upper margin is about 6cm from suprasternal notch Horizontal extent: left side upto posterior border of sternocleidomastoid muscle and right side about 2cm medial to anterior border of sternocleidomastoid muscle.
- 16. All borders well defined Surface appears smooth Skin over swelling appears normal Tattoo mark over the swelling present Moves vertically upwards with deglutition Does not moves with protrusion of tongue No other visible swelling in the neck No engorged veins over neck or upper chest
- 17. PALPATION No local rise of temperature or tenderness All inspection findings about size, shape, borders and surface are confirmed by palpation Firm in consistency Nodule mobile both horizontally and vertically Right lobe of thyroid is palpable, firm in consistency B/l carotid pulse palpable Trachea is slightly deviated towards right side
- 18. Palpable lymph nodes present in right posterior triangle •Two in number •Soft in consistency, non tender •Each about 1*1cm, flattened surface •Mobile •Skin over the lymph nodes normal
- 19. PERCUSSION: resonant note present over manubrium sterni ASCULTATION: no bruit over the swelling
- 20. SUMMARY A young female presented with swelling in front of neck since 6years, which was gradually progressive in nature with no pressure symptoms or any specific symptoms suggestive of hypo/hyperthyroidism. On examination, 6*8cm firm non-tender nodule found which moves on deglutition, with well defined borders.
- 21. PROBABLE DIAGNOSIS Benign euthyroid solitary nodule in left lobe of thyroid
- 22. THANK YOU