40.K.Aishwarya

 


A 56 year old male came with complaints of abdominal distension from 2 days 

Pt was apparently asymptomatic 2 and half months back ,then he developed pedal edema -pitting type grade 1 then gradually progressed to grade 2 over 10 days to grade 3 over 15 days

He first developed left lower limb swelling extending upto his ankle and he later gradually developed swelling of his right lower limb and the swelling in both his lower limbs extended upto his thighs

no complaints of fever, cough, burning micturation, loose stools, vomiting

No complaints of dyspnea, hematuria, frothy urine, no complaints of Chest pain, palpitations, orthopnea, PND

H/o pulmonary koch's 22 yrs back ,used ATT for 6 months

HTN since 2 months

PERSONAL HISTORY
Married
Appetite-decreased
Regular bowel and bladder movements
Occasionally alcoholic


GENERAL EXAMINATION : 
Patient is conscious, coherent and cooperative  
Moderately built and moderately nourished 
Pallor present ,grade 3 clubbing
No Icterus, cyanosis Lymphadenopathy

B/L pitting type upto thighs

VITALS : 
Temp: afebrile 
PR: 120 bpm 
BP: 160/80 mm hg 
RR: 24 cpm  
Spo2 - 96% at RA  

CVS : 
S1, S2 heard , No murmurs 

RS : 
Position of trachea: central 
Bilateral decreased air entry + 
Expiratory wheeze + in all areas

PER ABDOMEN: 
Abdomen distended with no scars, sinuses, engorged veins 
No tenderness 

Percussion-
Shifting dullness +

Bowel sounds +

CNS: 
Patient is Conscious ,oriented to time,place and person 
HMF -intact 
Motor & sensory system: normal 
Reflexes: present 
Cranial nerves: intact 
No meningeal signs 


PROVISIONAL DIAGNOSIS-
NEPHROTIC SYNDROME WITH HTN

Comments

Post a Comment

Popular posts from this blog

Prefinals general medicine

Image
1) Define heart failure. Etiology and clinical features of heart failure? How do we diagnose heart failure clinically , physical examination and various modalities used in diagnosis of heart failure.    2) Define cirrhosis of liver. Etiopathogenesis of cirrhosis. Write a brief note on clinical features diagnosis and treatment of chirhosis of liver. 11) acitic fluid analysis  12) protein pump inhibitors  15) differential diagnosis of fever with rash 16) insulin therapy in diabetes mellitus 20) hormones secreted by pituitary gland 4)Etiology of plural effusion and diagnostic criteria 5)diagnosis and treatment in dengue fever 10)complications of dialysis  3) elaborate on clinical features and diagnostic modalities in diagnosis of renal calculi 9)etiology and treatment of pneumonia  7) treatment of acute pylonephritis 6)clinical features and diagnosis of peptic ulcer disease  8)treatment of abdominal tuberculosis  17) antihypertensive drugs in chronic renal failure
Read more

A 46 yr old male with chest pain-

Image
  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 A 46 yr old male patient presented to the opd with the chief complaint of chest pain, increased sweating and pounding of heart since one month. History of present illness: He was apparently normal 1 month back then he developed chest pain profuse sweating and palpitations.   Then he went to nearby hospital .There he was diagnosed with coronary artery disease , given medication and admitted for 4 days then discharged. They suggested him to get angiogram done. Now after one month he presented to the opd with the similar problems. He noticed that chest pain increased upon climbing stairs and brisk walk
Read more

Gastroenteritis

Image
  Case of Gastroenteritis December 05, 2021  Case of Gastroenteritis  A 70 year old female presented to opd with chief  complaints of lower back pain since 10 days and  Blebs on right foot since 20 days . Patient had a fever 15 years back,went to hospital for check up and got to know that she is hypertensive patient . 10 years ago patient had joint pains,mostly elbow joint (patient is not aware of sequence of the pain ) 8years back ,joint pains aggravated , started using medications , pain got subsided, stoped using medications and pains started again. 4 years ago underwent tooth extraction when she fell down doing some work. 3 years ago ,had fever ,admitted in our hospital, found that she had some renal problem (no records available ) and later discharged. One year ago ,patient had facial puffiness,generalized weakness with multiple joint pains. 5 months ago,had severe wrist joint pain with restricted movement, distal interphalangeal joint pain,proximal interphalangeal joint pain . 10
Read more