50 yr old Pancytopenia

June 28, 2023

A 50 YR OLD FEMALE WITH PANCYTOPENIA

Greetings to one and all who are currently reading my blog. This is Jasmisri,eighth semester medical student

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A 50 year old female farmer by occupation presented to the OPD with

CHIEF COMPLAINTS:

generalised weakness since 1 year

loss of appetite since 1 year

hematuria since 2 days

dizziness since 6 months

sob ( grade 2) since 6 months

fever since 1 week

itching on right side of neck since 1 month

HISTORY OF PRESENTING ILLNESS

Patient was apparently asymptomatic 2 years back then she developed swelling of left lower limb associated with pain and then swelling progressed to whole body due to which she got admitted to Osmania and was treated after which the swelling subsided. Patient was doing fine till 1 year of that event but then gradually developed generalised weakness, easy fatigability, loss of appetite,weight loss, sob ( grade 2-3) not associated with cough,cold or palpitations.

She has pruritus that also began with an inflammatory rash in her neck a month back that currently appears as a post inflammatory hyperpigmentation with a nodular appearance.

She has fever which is intermittent, low grade not associated with chills and rigors

She also has Hematuria for which she went to local hospital where she found to have Anemia for which she was transfused 5 units of blood in a span of 20 days and was discharged.

She was doing fine.

Since 6 months patient is experiencing similar complaints and went to hospital where she was found to have Anemia and got transfused 2 units of blood and came here as they were unsatisfied with the treatment there . She was admitted on Saturday July 08

PAST HISTORY:

Not a known case of HTN, DM 2 , CVA, CAD, TB , EPILEPSY ETC

She underwent hysterectomy surgery at the age 36 years after the third childbirth.

PERSONAL HISTORY:

mother of 3 children ( 2 sons and 1 daughter)

Diet - mixed

Appetite- decreased since 1 year

Bowel and bladder- regular

Sleep-adequate

Allergies - No

MENSTRUAL HISTORY:

Menarche - 13 years age

Past - A Regular cycle 5/30

Present - hysterectomy done at the age of 36 yrs

DAILY ROUTINE :

She wakes up at 5 o'clock and does her daily activities and then she prepares for breakfast and has breakfast at 7 o'clock and then goes for work and at 12 o'clock she has her lunch near the field and in the evening she gets home bt 7 o'clock and prepares for dinner, eats it and then goes to bed at 9-10 pm.

After symptoms:

She is not going to any work since 1 and half year she stays at home and takes rest.

GENERAL EXAMINATION:

Patient is concious , coherent, cooperative and l well oriented to time, place and person.

Poorly built and poorly nourished

Patient is examined in a well lit room after taking consent with adequate exposure.

Pallor -present

Icterus - positive

Cyanosis - negative

Kolinychia - negative

Clubbing - negative

Generalised lympadenopathy - negative