Patient Profile
M.P., a 29 year old Filipina female, Roman Catholic, residing at Brgy. Tatalon, Quezon City was admitted on September 1, 2009 for the first time.
The patient is married with 3 children since 2000. The patient is a housewife while her husband, a laborer working in South Korea, provides financial support for the family. The patient used to work in a tuna factory in General Santos City before she migrated to Manila.
The patient usually wakes up at 7am then eats breakfast around 10am. At 12 noon the patient takes her lunch and then dinner by 7-8pm. The patient consumes 4 cups of rice and viand, for breakfast, lunch and dinner. No food preference was noted. The patient takes bread or rice with viand for her snack.
The patient does not smoke but admits taking alcoholic beverage once a week consuming 4 glasses of red horse beer per drinking session. The patient does not have any history of intake of prohibited drugs. Caffeine intake is 2 cups per day, one in the morning and one in the evening. The patient is fond of taking carbonated drinks, consuming about a liter everyday.
Chief complaint
Generalized body weakness of 1 day duration and difficulty of breathing of 8 hours duration.
Source and Reliability
The patient with good reliability.
HPI
August 29,2009 –the patient had a drinking session on her birthday, claims that this was the first time in a long time na uminom sya. This involved redhorse grande (malakas ang sipa haha). She said she was able to drink about four glasses of beer. After this there was a sensation of nananakit and namamanhid ang proximal legs na para bang ung pagod na pagod na feeling na parang naglakad ka buong araw . parang cramps. no other associated signs and symptoms. C – cramp like pain; L – proximal legs, bilateral, then gradually progressing to distal legs, pero nagprogress na ito kinabukasan na ha; I – tolerable pain, kaya pa naman maglakad; T – persistent; AA – no alleviating, no aggravating. Natulog na lang si patient.
August 30,2009 - nanakit and namanmanhid pa rin ang lower legs and the muscles seemed hard or taut. Nagpahilot sya and uminom ng flanax and alaxan ,during meals but was unrelieved. Unable to stand at this point. symptoms persisted up to aug 31 with same CLITAA, pero yung location kumakalat sa katawan. Nauna sa legs, then habang lumilipas ang oras pati sa arms na. meds the same pa rin, nsaids after meals.
September 1, 2009
1-6 am the patient was unable to sleep due to the pain and unable to lift her hands,legs. There was difficulty of breathing, and was brought for consult early in the morning and was literally carried.
Current medications include Ambroxol ,co-amoxiclav and kalium (Hindi ko pa sure kung sino nagprescribe nito, update ko kayo pag nalaman ko na, sorry  )
Past Medical History
There has been no similar episodes of generalized body weakness in the past. (Meron yung patient easy fatigability, so localized body weakness?) The patient also had no history of prolonged sore throat, asthma, prior surgeries, accidents or major trauma.
The patient was hospitalized due to child birth. Labor was unremarkable and did not have complications. Immunizations were unrecalled.

Family history
51 breast ca acciden t
29 27
There are no known major illnesses in the family, nor are there any similar illnesses.
Review of systems
All normal except
Cough of 1 week duration – may sputum ba? Sabi ni anne meron daw..wala kasi ako narinig na sinabi eh, pero confirm ko pa rin. Update ko ulit kayo bukas.
Confirmed nocturia – with gradual onset since 2005, after nya sa 3 rd pregnancy, bumabangon 1x or
2x at night para magwiwi
Patient also eats a lot, 4 cups of rice every meal tapos bread or 2 cups of rice for her snack. Started around 2005, after her 3 rd pregnancy rin. Patient also drinks a lot, at least 8 glasses of water a day, wala pa dun yung coke litro na iniinom nya at kape, at yung thirsty feeling na lagi nya nararamdaman.
Polyuria – marami daw sya umihi, although hindi na ma-quantify. Basta sabi kung ano ininom nya, ganun din yung nilalabas nya.
Polyphagia, polyuria, polydipsia = diabetes insipidus? Kaya na bahala kung consider nyo itong info na ito 
Easy fatigabilty – hindi na matandaan kung kelan pa, basta matagal na daw
PE on admission
Conscious, coherent non ambulatory
BP 100/70,HR= 92,RR=18,temp 36.7
Anicteric sclera, pink palpebral conjunctivae
Adynamic precordium, normal rate, regular rhythm, disctinct s1 and s2 no murmurs
Equal chest expansion, clear breath sounds, no retractions
Flat normocative bowel sounds
No edema no cyanosis
Labs
Chest x-ray unremarkable

September 1
CBC
MCH
Hematocrit
MCV
MCHC
RBC
Platelet
RBC morphology
September 1,2009
30
39
80
32
4.0
72
Normochromic, normocytic
Urinalysis
Specific gravity 1.005 besides that all other results were normal
Blood gases normal pH 7.46 7.35-7.45 pCO2 32 35-45 pO2 98 80-100
HCO3 22.9 22-26
Potassium normal
September 1 0.68 mmol/L 3.5-5.3
September 2 1.9 mmol/L
September 3 2.7 mmol/L
September 4, 2009
Ultrasound
Bilateral diffuse renal parenchyma disease with focal nephrocalcinosis on the right. Normal urinary bladder.