Case presentation steps:

Patient identification – age, sex, weight, admission reason

Chief complaint – main symptom and duration

History of present illness – onset, progression, key associated symptoms

Past history – medical illnesses and previous surgeries/anesthesia

Medications & allergies – current drugs and any known allergies

Physical examination

• General condition and vital signs

• Relevant systemic findings

• Airway assessment (if anesthesia case)

Investigations – important laboratory and imaging results

Diagnosis – provisional or confirmed

Management plan – treatment, surgical procedure, and anesthesia plan if applicable

this is example of case presentation prepared by Bzhwen Araz as lab assistant in anesthesia department