Short case 1

 Short case 1:

A 70 year old Paddy farmer, came to OPD with c/o B/L pedal edema and shortness of breath since 6 months


Pt was apparently asymptomatic 6 months back, then developed B/L pitting type of pedal edema upto thighs, facial puffiness, anasarca. Then he went to a private hospital in Hyderabad, during routine investigations was told to have elevated creatine levels and was told to undergo dialysis

Pt then came to KIMS, NKP for further management. 

Pt has lost his livelihood since the last 6 months because he's been unable to work. He's survived by his wife and his son who lives elsewhere. He also has two daughters but they don't live with him.

C/o B/L hip pain since 6 months 


No c/o decreased output of urine


No h/o Fever, cough, cold


In KIMS, KNO, pt underwent 10 sessions of dialysis


1st-8/12

2nd-11/12

3rd-15/12

4th-22/12

5th-27/12

6th-31/12

7th-8/1

8th-17/1

9th-22/1

10th-26/1


Patient is a k/c/o Hypertension and DM since 20 years, on regular medication.

Started on insulin 4months back, twice a day, 10-20 units of insulin


Not a k/c/o TB, Asthma, Epilepsy 


Operated for inguinal hernia 4 years back

H/o Burn 6 years back


Vitals:


Temp- 98.6F


BP- 140/80 mmhg


PR- 86 bpm


RR- 17 cpm


Spo2- 99% at RA




General Examination:


Patient is conscious/coherent/cooperative 


Moderately built and well nourished


Pallor +


Icterus -


Cyanosis -


Koilonychia -


Lymphadenopathy-


Pedal edema + upto ankle 


CVS- S1 S2 + No murmurs 


RS- BAE+ No added sounds 


P/A- Soft, Non tender 

CNS : NAD

















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