This is an online E log book to discuss our patient's de-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"
67 year old male resident of gundepalli complaints of headache since 15 days
HOPI: patient was apparently asymptomatic until 15 days back. Then he had insidious onset of unilateral headache left side dragging pain radiating to neck accompanied with decreased intenditor speech , decreased fluency . Memory loss
No c/o fever , fatigue , giddiness
No c/o cough/ cold
No c/o burning micturition
No c/o nausea, vomitings, loose stools
PAST HISTORY:
Not a known case of Dm/HTN/TB/asthma/epilepsy
PERSONAL HISTORY :
normal appetite
Mixed diet
Regular bowel and bladder movements
No known allergies
No addictions
FAMILY HISTORY: Not significant
GENERAL PHYSICAL EXAMINATION:
No pallor icterus cyanosis clubbing lymphadenopathy
Vitals:
Bp-110/80mmhg
Pr-100bpm
SYSTEMIC EXAMINATION:
CVS: S1s2 +, No murmurs
Rs: BAE+, NVBS heard
PA: soft ,non tender
CNS:
1-Informant: Lukapati
2-Education: uneducated,illiterate
3-Occupation :farmer (stoped 6months back)
4-Handedness: right
5-Physical appearance:
a)personal cleanliness : good
b) dressing habits :
c) motor activity : masked like face
6-Attention( non spatial)
7-Attention( spatial)
8-Mood ,emotion , behavior-normal
9-language
Spontaneous speech:normal word output
Verbal fluency:
Comprehension:
Repetition:
Naming:
Reading:
Writing:
10-Memory
Immediate:
Recent/short term memory
Report memory: Intact ,
visual memory +
11- Higher cognitive function testing
12- apraxia
Ideo motor apraxia:
Ideational apraxia:
TEMPORAL LOBE
Memory:
Recent memory -intact
Remote memory -intact
New learning ability
Visual memory
PARIETAL LOBE
1- neglect
2-simultagnosia
3-apraxia
4- constructional ability
5- calculation :
simple addition+
Substraction -
Multiplication +
6- right left orientation
7- finger agnosia
8-geographic orientation
9-cortical sensation
Stereognosis
Graphesthesia
FRONTAL LOBE
- attention/working memory
- Set shifting
- Trail b test
- Sequence test
- Verbal similarities
- Verbal fluency
- Conflicting instructions/ sensitivity to interference
- Inhibitory control
- Proverb interpretation
- Environmental/autonomy
- Judgement
- Insight
OCCIPITAL LOBE
1.prosopagnosia
- Visual object agnosia

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