Case history-1



 Welcome and greetings to every one who are visiting my blog. This is an online E log platform to discuss our patient's de-identified health data shared after taking his/her/guardian's signed informed consent. I have been given this case in order to solve in an attempt to understand the topic of patient's clinical data analysis to develop my competency in reading and comprehending clinical data and come up with a diagnosis and treatment plan.

A 37 year old male driver by occupation came to OPD with chief complaints of shortness of breath,pedal edema, decreased urine output since eight months.

HISTORY OF PRESENT ILLNESS:

Patient is a driver by occupation residing in Damer.

Patient was asymptomatic four years ago.

He had decreased appetite,flanks pain for which he visited hospital.He had history of deranged renal function tests.

Patient had two sessions of hemodialysis and is on conservative management for four years.

Eight months ago patient came to casualty with complains of  shortness of breath, pedal edema and decreased urine output for which hemodialysis was done.

HISTORY OF PAST ILLNESS:

Patient is a known case of hypertension since eight months.On tablet nicardia 10mg PO/BD.

PERSONAL HISTORY:

Appetite: normal

 Diet:mixed.  

Micturation: normal 

Socio-economic: moderate

Patient used to consume alcholol four years ago

GENERAL EXAMINATION:

The patient was concious, cooperative, coherent and well oriented to time,place and person.

No icterus,cyanosis and clubbing.

Edema of feet and pallor seen.

VITALS:

Temperature:afebrile.

B.P:140/70mm/hg.

Respiratory rate:17/min.

PR:98%at room temperature.

CVS examination:

S1&S2 heard,no yhrills,no murmurs.

RESPIRATORY:

Vesicular breath.

Trachea in central position.

No wheezing.

No dyspnea 

ABDOMEN:

Shape:scaphoid.

No tenderness.

No palpable masses.

Normal hernial orifices.

No free fluid.

Not palpable spleen 

No bowel sound heard 

CNS:

Concious and normal speech 

Normal gait 

Sensory symptoms are normal 

Motor systems are normal

Cranial nerves are normal

INVESTIGATIONS:















Provisional Diagnosis:
Chronic kidney disease on MHD secondary to hypertensive nephropathy
.
TREATMENT:
On from 14-02-20222 to 23-02-2022

Fluid restriction:less than 1.5ltres per day 

Salt restriction<2gm/day 

Tab.Nicardia 20mg PO/BD 

Tab.Arkamine0.1mgPO/BD 

Tab.Nodosis 500mg PO/BD 

Tab.livogenPO/BD 

Tab.shelcal C5 PO/BD

Inj.erythropeitin 4000I.U SC weekly twice 

Bp monitoring.





















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