63yr old female patient with hypoglycaemia
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chief complaints:
65 year old female patient non diabetic non hypertensive who is a Telugu tutor at home and was able to do all her house hold works on her own till 2006 then from 2006 she was getting water from step well then she got her hipand knee pains from 2008 where they took to hospital they suggested for surgery but Attendors neglected it because of financial issues then from that time patient was slowly walking from 1 year she started walking with the support(wall) and do her own works then from few days she is walking with walker . Patient had odynophagia since 4 days then she did not take food and on the day of admission she got up in the mrng and was oriented to place time and person then after some time she was not oriented to person since afternoon then they brought patient to the hospital with complaints of
Altered behaviour since1 hr
Difficulty in swallowing since 4 days
Past history : N/K/C/O DM ,HTN, CAD ,Asthma, TB ,seizures
O/E :
No
Pallor, icterus, cyanosis,clubbing,lymphadenopathy,Edema
pt is c/c/c
Afebrile
PR: 98bpm
BP:110/70mmHg
RR: 18cpm
CVS: S1S2+
RS:BAE+
CNS:
Handedness: right handed
Consciousness: conscious
GCS: E4V5M6
Orientation: oriented to place time and person
Memory:
Immediate: intact
Recent: intact
Remote:intact
Attention: intact
Calculation: intact
Cranialnerves: normal
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