Tuesday, February 4, 2014

Case Sheet:

Dated: 4th, Feb, 2014.

Name:- Ms. Diksha Chhetri
Age- 22,    Sex- F.
Religion-- Polytheist.
Occupation-- Student.
Marital status-- Single.
Address-- Room no 23, KIMS girls hostel.

Chief complaints:- Pt. complains she is always confused- since 3 years.
                        -- Absurdity- since last 3 years.
                     

History of present illness-- The patient was apparently alright 3 years ago. To start with she was carefree and happy, with no aims and no particular ambitions. She had a good social life, with wide circle of friends and she was satisfied. But she started earning disapproval from her lecturers. In the rounds she noticed that she didn't know anything. This progressed and ultimately the pressure built up, and one day a lecturer told everyone to "Muu dekhaney ka layak banaoo tum log!". That day onward she started stream lining her activities and her social life got disrupted. She started avoiding all forms of social interaction and books were her new friends. She noticed that the more she read, the more confused she became. She is confused about what to read, how to read and what next after this. Complains that she is now confused about everything, but all the while has gained ambitions and motivation.
The confusion is exacerbated by good movies, fashionable clothes/make-up/boys and on seeing her other peers having lots of fun and not always stuck in the library. 
The confusion doesn't subside even after sleeping snugly for hours at a stretch. She gets temporary relief from confusion while she is day dreaming which occurs several times a day.

Absurdity- She plans of doing many things while studying MBBS which are remotely possible. Like playing tennis at nationals levels or learning to swim like a mermaid, or reading too many literary novels, and crashing parties.  She also uses Facebook to show the world that she is having lots of fun and not studying, which she says is a decoy to let others think she is a fun person.
Complains of being teased by her non-medical peers by words such as 'nerd'/ geek wannabe and says that she feels angry instead of scared.

She also complains of episodes of extreme frustrations during which she acts very blindly. Once or twice in a year.


History of past illness-- Past history of being too weird and petulant and immature and rash. Has many records of stupid stories to her name.
Past history of severe depression but has recovered now and doesn't feel negative anymore.

Personal history: Occasional drinker which are all marred by embarrassing/ humiliating stories.
-Non-smoker.
-Hypochondriac.
-Foodie and a work-out freak.

Diet-- Dal and bhat and alo---everyday. (hostel food!)

Drug history-- Iron tablets and vitamins. 
                  - Calcium sandoz on daily basis (told ya shes hypochondriac).

On examination:- The patient is in-cooperative. (but she is a sweet young beautiful lady unlike what she describes in her history).

Provisional diagnosis- A normal medical student. 

Treatment: 1)Ignore her rants.
                  2) Never ask her 'how's studies going on?'
                  3) Advised to cook grand twice a month and eat with similar friends.
                  4)Advised to find a group of study pals (which she has :) )
                  5) Advised to work smartly.



peace- dr. Diksha.