complaint shivering of hands and legs since 2 months

This is an a online e log book to discuss our patient de-identified health data shared after taking his / her / guardians signed informed consent. Here we discuss our individual patients problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problem with collective current best evident based input.



This E blog also reflects my patient centered online learning portfolio and your valuable inputs on the comment box is welcome.I have been given this case to solve in an attempt to understand the topic of " patient clinical data analysis" to develop my competency in reading and comprehending clinical data including history, clinical findings, investigations and come up with diagnosis and treatment plan



The patient/ attender was informed the purpose of the information being acquired. An informed consent was taken from patient/ attender and there is omission of information that was requested to be omitted. 
Cheif complaints : 
C/o shivering of hands and legs since 2 months
C/o swelling in front of neck, moving with degulition
Patient was apparently asymptomatic 10 months back and then developed shevering of both hands and legs, insidious in onset and gradually progressive and associated with palpitations, increased appetite, increased frequency of stools, excessive sweating and weight loss, no h/o fever breathlessness
Past history: not a known case of dm, hypertension, epilepsy 
K/c/o bronchial asthama since 7 years using sos
General examination: 
Pt is c/c/c moderately nourished and built
Bp : 120/70mmhg
Pr: 111bpm
Rr: 17
Grbs : 118mg/ dl
Cvs : s1 s2 heard
Rs : nvbs , 
Cns : no fnd
P/a : soft non tender
Provisional diagnosis:
Thyroditis with thyrotoxicosis k/c/o bronchial asthma









https://youtube.com/shorts/9V9TCWY6e-w?si=6kZfGDZPk1RSOHKn
https://youtube.com/shorts/xXLbHT6_9fI?si=Up8xVVC0RV4AAnRb

Treatment given :-
Tab. Prednisolone 30 mg OD 
Tab. Pan 40 mg OD 
Tab. Thiamine 100 mg PO BD
Tab. Neurobion PO BD
Tab. MET-XL 12.5 mg PO BD

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