A 50 year old with sob,pedal edema

"This is an online E log book to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent.Here we discuss our individual patient's problems through series of inputs from available global online community of experts with an aim to solve those patient's clinical problems with collective current best evidence based inputs.This E log book also reflects my patient-centered online learning portfolio and your valuable inputs on the comment"

A 50 year old female patient came to casuality with complaints of pedal edema since 3 months ,decreased urine output since 3 months ,shortness of breath since 3 days

HOPI

Patient was apparently asymptomatic 3 months back then developed fever -low grade not associated with chills

Pedal edema 3 months ago

Decreased urine output 3 months ago

Sob -progressed to grade 4i

Patient was advised for hemodialysis but pt attendees were not willing

Patient has been taking nsaids since past 20 years for her Menstrual cramps

K/C/O HTN since 2 months

GENERAL EXAMINATION -

Patient is Conscious, coherent,co operative well oriented to time,place,person

pallor-+

No icterus, No Cyanosis, No lymphadenopathy

VITALS-

Temperature -98.6F

Pulse rate- 84bpm

Blood pressure-120/90mm hg

Respiratory rate -16cpm

SYSTEMATIC EXAMINATION:

CARDIOVASCULAR SYSTEM:

S1,S2 heard, NO Murmurs

RESPIRATORY SYSTEM:

BAE present,NVBS

CENTRAL NERVOUS SYSTEM:

NAD

PER ABDOMEN:Soft, non tender

No guarding, No rigidity

Bowel sounds present

Investigations -

Diagnosis

Chronic renal failure

Treatment

1.TAB LASIX 40mg IV/BD

2.TAB NODOSIS 500mg PO/OD

3.TAB SHELCAL PO/OD

4.TAB BIO D3 PO/OD

5.TAB OROFER XT PO/OD

Comments

medicine case

This is online E log book to discuss our patient’s de-identified health data shared after taking his/her/guardian’s signed informed consent. Here we discuss our individual patient’s problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs A 79yr male presented to casuality with chief complaints of pedal edema since 10 days , shortness of breath since 5 days Patient was apparently asymptomatic 10days back then came with c/o Pedal edema since 10 days -pitting type ,shortness of breath since 10 days insidious in onset , grade 3(marked limitation in activity) ,Fever 7 days back which subsided ,Dry cough 7 days back which subsided. PAST HISTORY - K/c/o hTN since 10 yrs on regular medication-telmisartan 40mg H/o CVA 10 yrs back for which he was treated. Not a k/c/o diabetes , TB,asthama,cvd , epilepsy. PERSONAL HISTORY - Diet - mixed Appetite - n

Medicine case

CASE HSITORY AND CLINICAL FINDINGS 29 year old female patient came to the casualty with h/o consumption of rodentiscide paste / ratatol poisoning 6days back [ 10 gm - approx. containing 3% yellow phosphorus ] followed by complaits of 1 episode of fever with chills 4 days ago subscided with medication . complaints of vomiting since 4 days 2to 3 episodes per day ,food as contents complaints of yellowish discolouration of eyes and body since yesterday associated with discolouration of urine and dcrease appetite since 2 days . patient visited to local RMP yesterday morning she under went investigations : her Hb 3.7 gmd /dl ,TB : 5.6 DB 3.2 AST 270 ,ALT 340 ,ALP 135 ,TP 6.4 ,albumin 3.9 globulin 2.5 complaints of burnung sensation in chest ,giddiness today morning associated with palpitations so she was brought to our hospital, no history of loose stools, pain abdomen, bleeding gumsno discouluration of stools ,no h/o sob ,blood in stools ,h/o fever 7 years ago, she got tested and was tol

case presentation

This is an online e logbook to discuss our patients deidentified health data shared after taking her/guardian's signed informed consent Here we discuss our individual patient problems through series of inputs from available global online community of experts with an aim to solve those patients clinical problems with collective current best evidence based inputs This E log also reflects my patient centre’s online learning portfolio and valuable inputs on the comment box is welcome. A 45 year old gentlemen ,from ramanapet who is farmer by occupation came to the OPD with CHIEF COMPLAINTS: B/l Pedal edema since 3 months Shortness of breath since 2 months HISTORY OF PRESENT ILLNESS: Patient was apparently asymptomatic 3 months back then developed pedal edema, insidious in onset, bilateral ,gradually progressive from involving ankles to limbs (grade1to grade 3 ), pitting type ,aggravated by walking and by end of the day,relieved by elevating leg, then developed shortness of breath w

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