A 65 Year old female came to the OPD with complaints of burning micturition and lower back pain

 The patient's and his attender's consent was obtained, following which detailed history was taken and examination was performed.

HOPI

The patient was apparently asymptomatic 14 days when she developed left flank pain and burning micturition around the same time.
The patient was first taken to a local hospital and was later referred to this hospital.
The pain in her left flank is a stabbing type of pain.

Past History

She underwent hysterectomy surgery 23 years ago as per medical advice. She suffered with menorrhagia and dysmenorrhea prior to the surgery.
She suffered a road traffic accident 22 years ago. There is an internal fixator in her right lower limb(right leg).
She has had diabetes and hypertension since 20 years and has been taking medicines for the same.
(Cilnidipine 10 mg, Nifedipine) 
No history of thyroid disease, cardiovascular disease, asthma, TB or epilepsy.




Family history

No significant family history. 
Her husband had an angioplasty 4 years ago.


Personal history

Reduced appetite since a few weeks. Her tongue is sensitive to spices.
Mixed diet is being consumed.
She gets adequate sleep.
No addictions, no history of allergies.
She was vaccinated as a child.


General examination

Patient was conscious, coherent and cooperative during the examination.
She was moderately built. Moderately nourished.
No pallor, icterus, clubbing, cyanosis, lymphadenopathy or bilateral pedal edema.
Tongue appears to have mildly ulcerative lesions.












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