CASE OF SOB and DECREASE URINE Output
67 yr old male came to OPD with
Chief complaints : sob,cough, generalized weakness from 1month
Decreased urine output and pedal edema from 1 week
HOPI : pt apparently asymptomatic 1 month back then he developed sob which increased on lying down , exertion and decreased on sitting posture and rest and he has wheeze
No history of orthopnea, chest pain, PND
Cough from 1month associated with expectoration it is mucoid non foul smelling non blood stained
He has pedal edema and decreased urine output from 1 week
Past history : similar complaints 2 years ago
Not k/c/o htn,dm,cad,tb,asthma
Personal history:
Diet - mixed
Appetite - decreased
Bowel and bladder - regular
Habits- occasional alcoholic
Tobacco chewing and will smoke 20 beedis per day
Sleep - adequate
General examination conscious , coherent , cooperative
No pallor
Icterus
Cyanosis
Clubing
Lymphadenopathy
Vitals
BP 120/70mmhg
PR 79 BPM
RR 20
Spo2 95
Systemic examination
Respiratory examination
BAE +ve and normal vesicular breath sound heard
B/L crepts IN ISA
CVS
S1S2 heard
No murmurs heard
Abdomen
Soft non tender
No hepatomegaly and splenomegaly
CNS :. Higher motor and sensory functions are normal
Investigations
2D echo
ABG
Acute exacerbated COPD with type 2 respiratory
Failure with severe PAH