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