Case history -8

 October 18, 2021

     " This is online E log book to discuss our patient's de- identified health data shared after taking his/her guardians signed informed consent. Here we discuss our 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 comment box is welcome. "

 A 45 yrs old man presented to the opd with chief complaints of shortness of breath and swelling of the legs.

HISTORY OF PRESENT ILLNESS:

Patient was apparently asymptomatic 3 months then developed shortness of breath and swelling of legs

Patient was diagnosed as chronic renal failure and dialysis was initiated.

Patient is a known case of hypertension since 6 years.

Patient tested covid-19 postive 4 months back.

PAST HISTORY:

No history of any surgeries in the past.

No history of diabetes, asthma, CAD, epilepsy

Patient is a known case of hypertension.

FAMILY HISTORY:

No history of any surgeries in the family

No history of diabetes and hypertension.

PERSONAL HISTORY:

Appetite - normal

Diet - mixed

Sleep- adequate

Bowel and bladder movement- regular

No habit of smoking

GENERAL EXAMINATION:

Patient is conscious, coherent ,and cooperative

No pallor

No cyanosis

No lymphadenopathy

No icterus

No clubbing of fingers

VITALS:

Temperature- 98.4 degrees F

Pulse- 84 beats/min

BP- 140/100 mm of Hg

Respiratory rate- 24 /min

SYESTEMIC EXAMINATION:

CVS:

No thrills

S1S2 heard

RESPIRATORY SYSTEM-

No wheeze

Postion of trachea- Central

Breath sounds- Vesicular

ABDOMEN-

Shape- Scaphoid

No tenderness

No palpable mass

No brui heard

CNS:

Level of consciousness- Conscious

Speech- Normal

No neck stiffness

INVESTIGATIONS:





   
PROVISIONAL DIAGNOSIS:
CKD ON MHD
Known case of hypertension.

TREATMENT:

1. Tab. Lasix
2. Tab. Nicardia
3. Tab. Livogen
4. Tab. Shelcal
5. Inj. Erythropoietin
6. Tab. Cionidine
7. Tab. BIO- D3
8. Tab. MET-XL







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