45/F with well compensated liver cirrhosis

 Case of a 45 yr old female, school teacher by profession. 

History:

since menarche, her periods are irregular, happening 10-15 days late than expected.


In 2004, pt had accompanied her mom to a hospital for her uterine tumor Sx (mom's). During that time she was also screened for uterine tumor by Dr. USG was done which revealed gall stone. Sx was done within 2 months. Pt had no complaints or symptoms related to gallstone.


In 2004, while staying in the hospital to get her gallstone operated on, she was diagnosed with hypothyroidism. Since then on medication.


In 2007, she c/o lightheadedness while at school. Later went to a Dr. who found her to be hypertensive. Since then BP under control with medication.


In 2013, she c/o dizziness and malaise. Dr. detected DM. DM is under control with medication.


In 2019, while doing a whole-body checkup, USG was done which detected liver cirrhosis. Pt went to AIG, Dr. after doing tests prescribed atoz multivitamin tab along with another medication which she could not find, hence changed to Heptagon tab. Endoscopy was also done which detected few small polyps in fundus.


In 2021, went to Hyd to get further consultation for liver cirrhosis, USG was done and a rt ovarian cyst was detected. Also, a diagnosis of metabolic syndrome with well compensated cirrhosis of liver was made. Discharged with medications. 


She c/o black hairy tongue for the past 1 yr which appears and goes away on its own within few days. She doubts on eating sour items black spots appear more.


Pt claims to be feeling all right with no absolutely complaints. Just came in view of her USG abdomen report. ( outside )

Pt had lost wt from 85(2004) to 66(2022) kgs by controlling her diet.

Denied any history of addiction


sequence:

Hypothyroidism and HTN diagnosed in 2007


Diagnosed diabetes in 2013

Diagnosed ?metabolic syndrome in outside hospital ( doesnt fit in the critera ) with well compensated liver cirrhosis in 2019

ovarian cyst detected in 2021

black spots on tongue appearing and vanishing for the past 1 yr.


FAMILY HISTORY: 

Father - HTN,DM

Mom - HTN, DM, Uterus tumor Sx

Mom's cousin sisters- Uterine tumor Sx

Brother - DM  

















HbA1C - 7 

CURRENT MEDICATION: 

Thyronorm 100 mcg o.d

Olmezest AM 40 Olmesartan and Amlodipine OD

Aztor 5 OD

Glimi M1 OD


PROVISIONAL DIAGNOSIS: Well compensated liver cirrhosis, DM, HTN, Hypothyroidism




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