A 35 year old female patient with uncontrolled Diabetes mellitus with black patches on both lower limbs below the knee - GM CASE 9

6th June 2023
CASE STUDY 9

Hello, I am Saloni .S. Gangotri , a 5th semester medical student. This is an online elog book to discuss our patients health data after taking his/her consent. This also reflects my patient centered online learning portfolio.

CASE SHEET:

CHIEF COMPLAINTS:
c/o 
- Bilateral black patches on both lower limbs below the knee with swelling associated with pain.


HISTORY OF PRESENT ILLNESS:

Patient was apparently asymptomatic 1 week ago until she developed swelling bilaterally on both lower limbs below the knee with black patches with associated pain around them. The pain was sudden in onset, gradually progressive, burning type in nature, continuous, aggravated on walking and relieved on medication. The pain in both legs radiated towards the foot. She had similar complaints of swelling on left leg below the knee 1.5 years ago which was treated locally by application og MgSO4 and glycerine for 3 months. This was similarity also associated with pain and fever. 

h/o occasional burning micturition.
No h/o rash
No h/o nausea since 7 days.
No h/o fever 
No h/o constipation 
No h/o diarrhea 


ASSOCIATED DISEASES:

———

PAST HISTORY:

h/o HTN since 3 years and is on medication.
h/o DM since 1 year and is only insulin, 3 times a day.
No K/C/O  Epilepsy, TB, CAD, CKD, Thyroid disorders.


PERSONAL HISTORY:

Married.
Works in a fertilization company.
Is on a mixed diet.
Normal appetite.
Adequate sleep.
Regular Bowel movements. 
Has no known allergies.
Has no addictions.


FAMILY HISTORY:

h/o father, brother and mother having HTN and DM.


DRUG HISTORY:



GENERAL EXAMINATION:

-No palor
-No Icterus
-No cyanosis 
-No lymphadenopathy
-pedal edema present
-No clubbing of fingers














VITALS:

Temperature: Afebrile - 98.7°F

Pulse: 86 beats per minute

Respiratory rate: —18 cycles per minute

Blood pressure: 120/80 mm of Hg

SPO²: 98%

SYSTEMIC EXAMINATION:

Cardiovascular system:

No thrills
No murumurs
Cardiac sounds: S1, S2 present 

Respiratory system:

No dyspnea
No wheezing
Breath sounds heard: vesicular? yes

Abdomen:

Shape : Obese
No tenderness
No palpable mass
non palpable spleen
hernial orifices normal 
Non palpable liver
No free fluid (ascites) present 
No bruits
Bowel sounds: heard




Central Nervous System:

Conscious and Alert 
Speech: Normal

INVESTIGATIONS:
Biochemical investigations:

ECG:


2D-ECHO REPORT:



ULTRASOUND REPORT:




GRAPHIC SHEET :





PROVISIONAL DIAGNOSIS:
———






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