General medicine E- log
HI,Iam Aziza of 6thsem medical student.This is an online elog book to discuss our patients health data after taking his consent.This also reflects patient centred online learning portfolio A 70year old male patient with chief complaints of SHORTNESS OF BREATH and fever since 3 days HOPI: patient was apparently asymptomatic two months back then he developed shortness of breath during eating,walking for a distance of 0.5km relieved on medication Fever since 3 days which is intermittent relieved on medication PAST HISTORY: Developed jaundice 2 months back Duodenal ulcer D1 1 month back Stunt placed in the heart two months back due to myocardial infarction PERSONAL HISTORY Diet mixed Appetite normal Sleep adequate Bowel nd bladder normal No burning micturition Addictions-alcohol GENERAL EXAMINATION: Patient was conscious coherent and well oriented with time place and person.. icterus is Present No cyanosis,clubbing,koilonychosis,lymphadenopathy,edema VITALS: BP-100/55 PULSE-70beats/min T