GM case 5

CASE scenario.....

Hi,I am K.Sathpriya,3rd BDS.This is an online elog book to discuss our patients health data after taking her consent.This also reflects my patient centered online learning portfolio 

                     CASE HISTORY 
Patient Details:
A 70 years old female,Occupation-Housewife,Resident of Bhongiri,Presented with
Chief complaints:
Patient came with the complaints of difficulty in walking and Unable to speak properly(Slurring if speech) Since 1day and Body pains since 1day.
History of present illness:
Patient was apparently asymptomatic 4 years back,then developed slurring of speech and diminision of vision,Difficulty in walking,which was relieved on medication,Now there is again an onset of the same condition since 1 day.
History of past illness:
*Hypertension-since 10 years(on tablet-Nicardia 20 mg)
*Diabetes mellitus-since 10 years(Mixtard insulin 18U in Morning and 12U in the night since 1&1/2Month)
No Tuberculosis 
No Epilepsy 
No CAD 
NO Asthma
Family History:
No similar complaints 
Personal History:
Diet-Mixed
Appetite-Normal
Sleep-Adequate 
Bowel&Bladder-Normal
Micturition-Normal
Drug History:
PrevaGold 10mg
Revacon 10mg
Nicardia 20mg
General examination:
Patient is conscious and Cooperative 
She lost her vision 5 years back(Diabetic Retinopathy)
Pallor-Absent 
Icterus-Absent 
Cyanosis-Absent 
Clubbing-Absent 
Lymphadenopathy-Absent 
Edema-Absent 
Provisional Diagnosis:
Acute CVA(Cerebro Vascular Accident)
Q/A
*What is the main cause of CVA?
*What might be the reason for reoccurance of symptoms even on medication?

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