27th February, 2023
MEDICAL
REPORT
H A, 47 YEARS, FEMALE
HOSP
NO: WCA/6052/2023
Diagnosis: Anxiety Disorder
Management: Referral to
Neuropsychiatry
She is 47yr old female, mother of two, senior
civil servant accompanied to the clinic today by her husband and mother.
Increasing concern of her excessive thought insertion especially about
unpleasant incidence in the past. It is affecting her work concentration and
sometimes considers her job is not worth it and considers quitting . There’s
however no suicidal tendencies. No history of hallucinations and delusions. There’s
increase in appetite and has consideration towards sweet drinks (coke and
plenty of water). There’s increase weight gain and insomnia.
Lab investigations results:
·
Fbs-10.17, 2HPP- 17.76, HBA1C- 7.4 All
were elevated.
·
FLP- total cholesterol- 426.3 is high
·
FBC, EUCR were within the normal limit.
Chest X-ray done
appeared normal.
Plan:
·
To be reviewed by neuropsychiatries as soon as
possible (appointment on 9th March, 2023 at 3pm)
·
For endocrinologist review.
Kindly revert for further clarifications
if need be.
Sincerely yours,
Dr.
Halima Ibrahim
For
Team Wellington Clinics