46YR OLD FEMALE WITH SHORTNESS OF BREATH AS CHIEF COMPLAINT.

This is an online e logbook to discuss our patients deidentified health data shared after taking her/guardian's signed informed consent

Here we discuss our individual patient problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs


This E log also reflects my patient centre’s online learning portfolio and valuable inputs on the comment box is welcome.



CASE:  A 46 year old female, housewife resident of Nalgonda came to hospital with chief complaints of Shortness of breath since 5days 


History of presenting illness 

          She was apparently asymptomatic 5 days back then developed shortness of breath which was insidious in onset progressed gradually, aggravated in lying down (supine) position and relieved on medication. 
She has history of cough with expectoration since 5 days, chest tightness associated with shortness of breath since 5 days.
Associated with orthopnea, wheeze, paroxysmal nocturnal dyspnea. 
Generalised edema since 5days which is insidious in onset. 

PAST HISTORY :
- K/c/o copd since 12yrs and is on inhaler. 
- K/c/o hypertension since 12 yrs on regular medication (telmisartan)

GENERAL EXAMINATION :
Raised JVP

RESPIRATORY EXAMINATION 
Inspection : Deviation of trachea to right side. 
Palpation : slight tracheal deviation to right side. 
Auscultation: 
- Rightside decreased breath sounds 
- Bilateral rhonchi present at suprascapular, interscapular, infrascapular, infra axillary areas
- Bilateral crepitations present at interscapular, infrascapular, infra axillary areas 




    




         

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