General Medicine case 4

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Date of admission:05/01/2022

A 35 years old female patient came with chief complaints of multiple joint pains since two months 

and oral ulcers since twenty days .

History of present illness:

Patient was apparently asymptomatic two months back and then she had a rapid menorrhagia (Heavy Periods) and multiple joint pains and she visited a hospital and she was found that thyroid and she was started taking of thyronome 100 mg.

And her menorrhagia was subsided ,but she have a multiple joint pains all small and large joints and swelling of joints and morning stiffness for 30 to 40 mins.

Since five days patient tells that her joints pains swelling are subsided.

 

Past history:

K/c/o: hypothyroidism (on thyronome 100 mg)

N/k/c/o:DM,HTN,CAD,Asthma 

No previous hospitalisation.

Personal history:

Died -mixed

Appetite-normal 

Bowel and bladder movements -normal 

General examination:

Patient is conscious,coherent,cooperative .

Pallor- positive 

 

No clubbing,icterus,cyanosis,lymphadenopathy,pedal

edema. 

Vitals:

PR-115bpm

BP-110/80mm/hg

RR-21/min

SPO 2-98%

Provisional Diagnosis:

Serum negative arthritis (2° to RA ?SLE) with k/c/o hypothyroidism.

Treatment:

 Thyronome 100mg

Riboflavin 5mg

Clinical Images:

ECG: