You are a foundation year doctor in GP. A patient presents with tingling in her hands.
1. Take a focused history from the patient.
2. Explain your differential diagnoses and management plan to the examiner.
Checklist
Checklist "MusculoskeletalHistory" not found
Management
Internally Approved
Surname/Nom (1)
Donovan
Given names/Prenoms (2)
Patricia
Date of birth/Date de naissance (4)
01 FEB 1972 (52)
Sex/Sexe (5)
f
PRESENTING COMPLAINT
You've been experiencing tingling and numbness in both hands for the past 6 months. It's particularly bad at night and often wakes you up. You need to shake your hands to get rid of the sensation. Recently, you've started dropping things at work.
IDEAS, CONCERNS AND EXPECTATIONS
You're worried because you work as a hairdresser and it's affecting your ability to hold scissors. You want to know if this can be treated as you can't afford to lose your job.
SYSTEMS REVIEW
The tingling mainly affects your thumb, index, and middle fingers. Your little fingers are fine. No neck pain. No weakness in arms or legs. The symptoms are worse when you're doing hair at work. You find yourself dropping things more frequently.
PAST MEDICAL HISTORY
Hypothyroidism diagnosed 2 years ago. No previous hand problems or injuries.
DRUG HISTORY
Levothyroxine 100mcg once daily. No known allergies.
FAMILY HISTORY
Mother had similar symptoms but never got it checked.
SOCIAL HISTORY
Works as a hairdresser for 25 years. Lives with husband. Non-smoker. No alcohol. Hobbies include knitting.
