Swelling and pain at hands,feet and elbow
Race: Caucasian white
History of present illness:
A 40 years old female applied to Rheumatology policlinic with a problem of swelling and pain at her hands,feet and elbow and a difficulty at her walking.She has had swelling and pain at her hands and feet for 3 or 4 years.And she doesnt respond to painkillers.She also have morning stiffness more then an hour which cause disability at walk.Also she has nodular swelling at her MCP and DIF joints.
She has Hypertension for 3-4 years.
She has been depressive and taking antidepressans for like 9 years.
She has been smoking for 10 pack year.
She has been told she has glocoma.
Past surgical history:
She had 2 times breast cyst excision operation which had benign results.
Candesartan cylectesil hydrochlorothiazid (for HT)1*1
Atorvastatin 40 mg 1*1
Aspirin 150 mg 1*1
Amlodipin 10 mg 1*1
Ketiapin 200 mg 1*1
Venlafaxin 150 mg 2*1
Her mother has DM,HT,Hyperlipidemi
She has been depressive and anxious for 9 years
She looks mild obesis
120/80 mm Hg
Head, ears, eyes, nose & throat:
They all look all alright.
She has tenderness at her right low quadrant by palpation
Ýt has been waited for.
She has tenderness at her MCP,DIF,wrist,elbow by palpation
Plan of treatment:
NSAIDs and a PPI for now.
I beleive she has RA,because of symettric joint inflamation and tenderness.
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