Tutorial Modul NefroUrologi A 50-year old man with headache and malaise Session I Part I on 1st day Mr. Ryan, a 50-year-old man, admitted to Jakarta Hospital with a 9-month history ofheadache and malaise. He told that he has felt lethargic and lacking in energy for around months. !his has "een much worse recentl y and has "een associate d with mild nausea and itchiness. !he headache has "een occurring for much longer pro"a"ly around #0 months. He gets it e$ery day, descri"es it as thumping of gradual onset and responsi$e to parasetamol. He has no associated neurological symptoms such as num"ness or weakness in the arms and legs, and no $isual distur"ance. He has not "een short of "reath on e%ertion, nor does he gi$es any history of orthopneual or paro%ysmal nocturnal dyspnoea. His ankles ha$e "een mildly swollen for a few weeks. Mr. Ryan was pre$iously $ery fit and healthy and has ne$er had any heart, li$er or kidney pro"lems. He has no that any urinary or prostatic symptoms. He does not take any regularmedica tions and is a non-smoker who drinks no alcohol. He works as a sales man, "ut is finding the daily tra$elling re&uired more and more difficult. iscussion Acti!ities #. 'ha t is Mr . Ry an(s me dic al pro "le ms) . *ook f or the medic al history to def ine y our wor king d iagnos is+ . 'ha t is your hypothesi s) %p lai n your answe r+ . 'hat do y ou do to assi st the hi story f or gett ing worki ng diagno sis) /More information+
