case 2 case of CKD

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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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