case 2 case of CKD

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-centred online learning portfolio and your valuable comments on comment box is welcome.

Name : K. Santosh Kumar
Roll no : 52
A 55 year old female came to casualty with complaints of SOB on exertion since 23days.

She was apparently asymptomatic 23 days ago. 
-she is experiencing SOB on exertion since 23 days which has been progressive (didn’t relieve with diuretics)
- pedal edema and facial puffiness since 20 days ( resolved now)
- H/o loss of appetite since 20 days
- H/o abdominal distension 
- No H/o decreased urine output 
-H/o low back pain since 3 years 
- h/o NSAID use since 20 days

She was treated as specified below and was discharged on 4th Oct 2021
Then about within 1 day she again developed Shortness of breath on doing regular activity 
No history of orthopnea and paroxysmal nocturnal dyspnea
No history of fever, vomiting,pain abdomen,loose stools,chest pain, palpitations.

Past history:
Diagnosed with diabetes since 15 years and on Inj HAI 4U TID
Hypertension since 20 years, on amlodipine 10mg.
- H/o gynecological surgery..underwent hysterectomy ?

Personal history 
Appetite is decreased 
Rest are normal 
Decreased urine output.

General examination
she is conscious, coherent and cooperative
Pallor - present 

Vitals - 
Temp - afebrile 
PR- 100bpm 
RR - 22cpm 
BP - 140/70 mmhg
Spo2 - 98% at room air 

Respiratory system
Chest is elliptical, bilaterally symmetrical
Equally moving on both sides with respiration
Apex beat is seen and felt at 5 the intercoastal space 1 cm medial to mid clavicular line 
Normal vesicular breath sounds Heard

Cardiovascular system
S1S2 heard no added sounds  
Clinical images


These pics are taken from the reference Link 
http://ramprasad116.blogspot.com/2021/10/55-yr-old-female.html

Provisional diagnosis
UTI
Renal failure secondary to nephritic syndrome
HFPEF ef- 58%
Iron deficiency anemia
Cardio renal type 5
Know case of Dm2 and HTN

INVESTIGATIONS:

USG. Finding
Rt side grade 2 RPD
Lt side grade  1 RPD
Rt simple renal cyst

Treatment history








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