A 68 year old female prsented with diminision of vision since 6 months with denovo hypertension

This is an online E log book to discuss our patient's d-identified health data shared after taking his/her/guardian's signed informed consent. 

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


This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment box is welcome.

Here is a case i have seen: 

A 68 year old female presented to ophthalmology opd with complaints of diminished vision since 6 months,diagnosed with right eye SMC admitted for cataract surgery referred to medicine opd in view of high bp recordings

Bp 220/120 mm of hg

No ℅ Headache vomitings dizziness 

neck pain is present occasionally 

No pedal edema 

shortness of breath on exertion present

 palpitations absent

She is using dexamethasone  and acyclofenac for body pains as prescribed by RMP

 not a known case of hypertension, diabetes mellitus, asthma ,epilepsy, CVA ,CAD


Personal history:

Diet :vegetarian diet

appetite: normal

Bladder and bowel :regular .

Sleep:adequate. 

addictions: none


General Examination:



Patient is conscious coherent and cooperative 

No pallor ,icterus,cyanosis, clubbing, lymhadenopathy,edema


Vitals:

Temperature: Afebrile

Pulse: 78bpm

Respiratory rate: 19cpm

Bp: 190/100 mm of hg

Spo2: 98% at RA


Systemic examination: 

Cvs: S1 S2 heard no additional sounds or murmurs

Rs: NVBS

Abdomen: soft,non tender

Cns: higher mental functions intact


Diagnosis :Hypertension urgency ? Steroid induced


Investigations:












Treatment :

Bp 2nd hourly monitoring 

Tab Clinidipine 10 mg bd

Salt restriction 

Tab nicardia 20 mg stat


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