IDENTIFYING DATA: The patient is a 52-year old male, married for 22 years with two children,

College graduate, previously working as a housekeeping manager, Roman Catholic, residing in

Singalong, Manila.
CHIEF COMPLAINT: nanginginig at nag palpitate pag nagsasalita habang nag conduct ako ng
briefing sa mga empleyado ko at pag nag attend ako Ng department head meeting.
HISTORY OF PRESENT ILLNESS:
35 years prior to consult, when patient was still in 4th year high school, he already noted
experiencing nervousness during a class reporting. He experienced stuttering, trembling or
shaking of body and difficulty recalling the report he had previously memorized. There was no
associated difficulty of breathing or palpitations. These symptoms happened only while in front
of a large audience (20-30 people).
Approximately 25 years prior to consult, patient was promoted to work as a Housekeeping Manager. In line with his work, he had to give seminars and orientations to his new employees. Patient again noticed experiencing stuttering, trembling, difficulty recalling his lines, palpitations, cold, clammy extremities and body stiffness while conducting a seminar or attending
meetings with his superiors (10-15 people). No medications were taken, no consults done. Patient would only try to calm himself every time this occurs. These signs and symptoms persisted.
This eventually led to patient losing self esteem and confidence at work prompting him to seek
consult.
PAST MEDICAL HISTORY
patient has no previous hospitalizations, no suicide history, no allergies to food or medicine. He is a known hypertensive with highest BP of 170/100, usual BP 140/90, no maintenance
medications were being taken.
SOCIAL HISTORY
Patient is a 15 pack year smoker, an occasional alcoholic beverage drinker. He denies
previous or current illicit drug use.
FAMILY HISTORY

There are no heredofamilial diseases in his family.

ANAMNESIS
Patient is the 6th child in his family. He had his Elemenatry education in the same school
where his mother was working. He was an average student with good relationship with his
school mates. He was also member of the basketball team.
During his high school days, there was an instance wherein he gave a wrong answer
during a graded recitation. His classmates then laughed at him. From then on, every time he
would recite he would feel nervous and unsatisfied with his performance.
While in college, his father died. He felt people did not respect his family as much as
they did while his father was still alive.
At age 18, he started to work as a room attendant in a Pampanga Hotel. He had a good
working relationship with his colleagues but upon finishing his contract he moved to Trader's
Hotel in Manila. Because of his good performance, he was recommended to transfer to Amanpulo resort in Palawan. Upon finishing his contract, he moved back to Pampanga to work for
another hotel. He was eventually promoted as housekeeping manager through the years.

VITAL SIGNS: BP 160/100, HR 98, RR 18 Temp 36.8C

PE/NEURO: unremarkable
MENTAL STATUS EXAMINATION:
Patient is well groomed, attentive and cooperative. He is unable to sustain eye contact,
mood is anxious with broad and appropriate affect. Speech is normal, no stuttering. No perceptual disturbances. There is continuity of thought. Thought content showed fear of public speaking. He was oriented to three spheres, intact memory, able to do serial 7, able to write a complete sentence, draw a clock. He has good impulse control with insight level 3.