E-log General Medicine (nephrology)


Introduction

65 yr old male came to the casuality with chief complaints pedal edema since 1 and half year.Decreased urine output since one and half year.SOB

History of present illness

Patient was apparently asymptomatic for 1 and half year back then he developed pedal edema which was gradual onset progressive in nature, came to kims for further investigations.

HISTORY OF PAST ILLNESS 

K/C/O   HTN

N/K/C/O   DM,Thyroid ,TB,Epilepsy,Asthma.

PERSONAL HISTORY

•Mixed diet

•Loss of appetite

•Sleep adequate

•Bowel and Bladder movements regular.

TREATMENT HISTORY 

•k/c/o HTN 
• Not k/c/o diabetes,CAD , asthma, TB.

•NO H/O chemo /radiation , blood transfusion.

•NO H/O previous surgeries.

FAMILY HISTORY 

Not significant.

GENERAL EXAMINATION

•Patient is conscious, coherent and cooperative

•Moderately built and Moderately nourished

•No signs of - Cyanosis

                       Clubbing

                        Icterus

                         clubbing

                        lymphadenopthy

•Pedal edema and Pallor present

VITALS
Temp: Afibrile
PR: 86bpm
BP: 130/90mm hg
RR: 22cpm

SYSTEMIC EXAMINATION

CARDIOVASCULAR SYSTEM


CVS: s1s2 heard
•No murmurs

RESPIRATORY SYSTEM:

•NVBS heard

•Breath sounds - vesicular

RS: NVBS+

ABDOMEN
P/A: soft, non tender, bowels sounds heard

CENTRAL NERVOUS SYSTEM:

•Intact

•No focal defect

CNS: NFND

PROVISIONAL DIAGNOSIS

- CKD ON MHD

TREATMENT 

Fluid restriction <1.5L/Day

Salt restriction <2G/day

TAB NICARDIA 10MG/PO/BD

TAB LASIX 40MG/PO/BD

TAB NODOSIS 550MG/PO/OD

TAB SHELCAL 500MG/PO/OD

TAB OROFER XT PO/OD

INJ ERYTHROPOEITIN 4000IU WEEKLY ONCE


Advice on Discharge

fluid restriction <1.5L/Day

Salt restriction <2G/day

TAB NICARDIA 10MG/PO/BD for 10 days

TAB LASIX 40MG/PO/BD for 10 days

TAB NODOSIS 550MG/PO/OD for 10 days

TAB SHELCAL 500MG/PO/OD for 10 days

TAB OROFER XT PO/OD for 10 days

T.PAN 40mg PO/OD/BBF

T.BIOD3 PO/OD

INVESTIGATIONS














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